Medical school: UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
Graduated: 2013
NPI: 1740603935
Practice Locations (1)
PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC
3550 S 4TH ST, 115 PMG MULTISPECIALTY CLINIC
LEAVENWORTH, KS 660485085
9133346800
Source: CMS National Downloadable File, September 2026.