Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 2003
NPI: 1083759831
Practice Locations (1)
PERMANENTE MEDICAL GROUP INC
19000 HOMESTEAD RD
CUPERTINO, CA 950140712
4083664400
Source: CMS National Downloadable File, September 2026.