Medical school: NOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
Graduated: 2015
NPI: 1992186845
Practice Locations (2)
11300 CORPORATE AVE, SUITE 342
LENEXA, KS 662191348
1500 SW 10H AVE, PROVIDER ENROLLMENT FINANCE
Topeka, KS 66604
Source: CMS National Downloadable File, September 2026.