Medical school: WILLIAM M. SCHOLL COLLEGE OF PODIATRIC MEDICINE
Graduated: 2017
NPI: 1821522962
Practice Locations (1)
PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC
8919 PARALLEL PKWY, SUITE 206
KANSAS CITY, KS 661121655
9133346800
Source: CMS National Downloadable File, September 2026.