Medical school: GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1990
NPI: 1962579391
Practice Locations (2)
1243 S RIDGEWOOD AVE
Daytona Beach, FL 321146127
1243 S RIDGEWOOD AVE
DAYTONA BEACH, FL 321146127
3862522504
Source: CMS National Downloadable File, September 2026.