Medical school: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated: 2018
NPI: 1699477950
Practice Locations (2)
1400 SW 5TH AVE, FL 5
PORTLAND, OR 972015509
10178 BURNT MILL LN
FRISCO, TX 750356971
Source: CMS National Downloadable File, September 2026.