Medical school: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduated: 1993
Offers telehealth
NPI: 1740490317
Practice Locations (1)
SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
2100 CHARLIE HALL BLVD
CHARLESTON, SC 294145832
8438524100
Source: CMS National Downloadable File, September 2026.