Medical school: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduated: 2008
NPI: 1134379654
Practice Locations (1)
PROVIDENCE MEDICAL INSTITUTE
4101 TORRANCE BLVD
TORRANCE, CA 905034607
3103037496
Source: CMS National Downloadable File, September 2026.