Medical school: MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduated: 1994
Offers telehealth
NPI: 1942252473
Practice Locations (1)
SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
400 OTARRE PKWY
CAYCE, SC 290333751
8038984566
Source: CMS National Downloadable File, September 2026.