Graduated: 2002
NPI: 1962599563
Practice Locations (2)
PROVIDIAN ANESTHESIA LLC
9202 LEESGATE RD
HURSTBOURNE, KY 402225001
8886022512
LEC ANCILLARY PLLC
1400 POPLAR LEVEL RD, SUITE 2
LOUISVILLE, KY 402171309
5026362003
Source: CMS National Downloadable File, September 2026.