Medical school: EAST TENNESSEE STATE UNIVERSITY QUILLEN COLLEGE OF MEDICINE
Graduated: 2018
NPI: 1740762947
Practice Locations (2)
LIFESOURCE OF NORTH CAROLINA
3205 RANDALL PKWY, SUITE 105
WILMINGTON, NC 284032565
9107429243
LIFESOURCE PRIME INC
3205 RANDALL PKWY, SUITE 105
WILMINGTON, NC 284032565
9107429243
Source: CMS National Downloadable File, September 2026.