Medical school: BRODY SCHOOL OF MEDICINE AT EAST CAROLINA UNIVERSITY
Graduated: 1990
NPI: 1871552810
Practice Locations (1)
VIDANT MEDICAL GROUP LLC
500 S ACADEMY ST, VIDANT ROANOKE CHOWAN HOSPITAL
AHOSKIE, NC 279103261
2522093360
Source: CMS National Downloadable File, September 2026.