Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 2007
NPI: 1982845376
Practice Locations (1)
THE SOUTHEAST PERMANENTE MEDICAL GROUP
750 TOWNPARK LN NW
KENNESAW, GA 301445579
7705145405
Source: CMS National Downloadable File, September 2026.