Medical school: UNIVERSITY MEDICAL COLLEGE OF KANSAS CITY
Graduated: 2000
NPI: 1689649071
Practice Locations (2)
MIRACL LLC
1000 W 10TH ST, PHELPS HEALTH
ROLLA, MO 654012905
5733649000
WASHINGTON UNIVERSITY
510 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 631101016
31436272001
Source: CMS National Downloadable File, September 2026.