Medical school: MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduated: 2009
Offers telehealth
NPI: 1720213895
Practice Locations (1)
NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC
980 JOHNSON FERRY RD, SUITE 1040
ATLANTA, GA 303421609
7702923490
Source: CMS National Downloadable File, September 2026.