Medical school: UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduated: 2003
NPI: 1114963717
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
5940 ULALI DR NE
KEIZER, OR 973031500
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
14406 NE 20TH AVE
VANCOUVER, WA 986861448
8008132000
Source: CMS National Downloadable File, September 2026.