Medical school: SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Graduated: 2024
NPI: 1114764099
Practice Locations (2)
393 E WALNUT ST, 5TH FL PHR GROUP PROVIDER ENROLLMENT UNI
PASADENA, CA 911880111
393 E WALNUT ST FL, SUITE 5
PASADENA, CA 911880111
Source: CMS National Downloadable File, September 2026.