Graduated: 2025
NPI: 1174415749
Practice Locations (3)
3030 W OLYMPIC BLVD, SUITE 217
LOS ANGELES, CA 900066507
2466 MONTROSE AVE APT, SUITE 2
Montrose, CA 910201476
2466 MONTROSE AVE, APT 2
MONTROSE, CA 910201476
Source: CMS National Downloadable File, September 2026.