Graduated: 2015
NPI: 1689060907
Practice Locations (2)
UNIVERSITY MEDICAL SERVICE ASSOCIATION INC
4202 E FOWLER AVE
TAMPA, FL 336206750
UT REGIONAL ONE PHYSICIANS INC
877 JEFFERSON AVE
MEMPHIS, TN 381032807
9015458336
Source: CMS National Downloadable File, September 2026.