0010-02248
Inactive
Yes
03/10/2010
01/25/2024
See: Actions-Adverse & Administrative Tab
Active Supervisor
| Name | Type | Status | Approved | Inactive |
| None Reported |
North Carolina Hospital Admitting Privileges
| Location |
| Wake Forest Baptist Medical Center |
Out of State Active/Inactive Licenses
Out of Country Active/Inactive Licenses
Address
Winston-Salem, NC
Information
PA School
| School | Graduation |
| Cuyahoga Community College Physician Assistant Program | 2007 |
Area of Practice
| Area Of Practice | Primary |
| Family Medicine | |
| Internal Medicine | Yes |
Current Membership in Medical Professional Organizations
Honors & Awards
| Honor/Award | Given By | Date |
| None Reported |
Public Service
| Name of Clinic | Service Description | Date |
| None Reported |
Current Academic Appointments
| Title | Institution | City, State, Country |
| None Reported |
Publications
Section 1: Adverse Actions
North Carolina Medical Board Public Actions
This section indicates whether the North Carolina Medical Board has taken adverse public action regarding the
licensee. Click on the link or links below to see an electronic copy of public documents associated with the
licensee.
Certain public documents, such as hearing transcripts, are listed but are not posted on the site. If the record
indicates a transcript is available, it may be obtained by contacting the Board.
NCMB public actions are posted on this site indefinitely.
| Date | Description | Link |
|
01/29/2024
| Consent Order |
View
|
Other Regulatory Board or Agency Public Actions
| Date | Name of Board/Agency | Action Taken | Link |
| None Reported |
Health Care Institution Suspensions and Revocations
| Date | Health Care Institution | Action Taken |
| None Reported |
Section 2: Administrative Actions
Actions listed in this section are considered non-disciplinary by the Board. In situations where
administrative actions are taken, the licensee may not have met certain statutory requirements or
may have failed to follow correct administrative procedures.
North Carolina Medical Board Reentry Agreement
The NCMB requires license applicants who have not actively practiced clinical medicine for two or more
years to complete a program of reentry to demonstrate that they are competent to practice. A reentry
candidate must complete a period of practice under the supervision of an approved mentor before he or
she can obtain a full and unrestricted license.
| Date | Description | Link |
|
09/14/2010
| Re-entry Completion Letter |
View
|
|
03/10/2010
| Re-Entry Agreement |
View
|
North Carolina Special Purpose Licensing Agreement
| Date | Description | Link |
| None Reported |
Malpractice Information
The Board is currently reviewing the care that led to this payment.
| Incident Date | Payment Date | Area of Practice | City, State, Country | Response |
| None Reported |
Misdemeanor/DUI/DWI Conviction Information
| Conviction Date | Conviction | Jurisdiction | Sentence |
| None Reported |
Felony Conviction Information
| Conviction Date | Conviction | Jurisdiction | Sentence |
| None Reported |