Medical school: UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduated: 1992
NPI: 1992891535
Practice Locations (1)
SSM REGIONAL HEALTH SERVICES
2511 W EDGEWOOD DR D, SSM HEALTH URGENT CARE
JEFFERSON CITY, MO 651095869
5737610304
Source: CMS National Downloadable File, September 2026.