Medical school: UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduated: 2004
NPI: 1871750364
Practice Locations (2)
140 STONERIDGE DR, SUITE 210
Columbia, SC 292108270
140 STONERIDGE DR, SUITE 210
COLUMBIA, SC 292108270
8034517600
Source: CMS National Downloadable File, September 2026.