Medical school: UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduated: 2005
NPI: 1013127075
Practice Locations (1)
LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER
1040 NW 22ND AVE, SUITE 168
PORTLAND, OR 972103036
5034137022
Source: CMS National Downloadable File, September 2026.