Medical school: STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduated: 2000
Offers telehealth
NPI: 1013005461
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES OREGON
9427 SW BARNES RD, SUITE 593
PORTLAND, OR 972256640
5032168670
Source: CMS National Downloadable File, September 2026.