Medical school: MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduated: 2024
NPI: 1114780475
Practice Locations (2)
4060 FAIRMOUNT AVE
SAN DIEGO, CA 921051608
21410 NE 14TH STREET
Sammamish, WA 98074
Source: CMS National Downloadable File, September 2026.