Medical school: UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduated: 2002
NPI: 1699961417
Practice Locations (2)
101 W PONCE DE LEON AVE, DECATUR PLAZA ANNEX/WESTFIELD
Decatur, GA 300302542
101 W PONCE DE LEON AVE, DECATUR PLAZA ANNEX
DECATUR, GA 300302528
Source: CMS National Downloadable File, September 2026.