Medical school: UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduated: 2013
NPI: 1225470354
Practice Locations (2)
PROVIDENCE MEDICAL FOUNDATION
1950 SUNNY CREST DR, SUITE 3500
FULLERTON, CA 928353646
7144084249
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
1221 MERCANTILE LN
LARGO, MD 207745374
3016185700
Source: CMS National Downloadable File, September 2026.