Medical school: NOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
Graduated: 2020
Offers telehealth
NPI: 1063033736
Practice Locations (1)
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
1301 20TH ST, SUITE 110
SANTA MONICA, CA 904042096
3104530419
Source: CMS National Downloadable File, September 2026.