Medical school: NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduated: 2003
NPI: 1235168006
Practice Locations (1)
NOOKSACK CENTRAL MANAGEMENT SYSTEM
2510 SULWHANON DR
EVERSON, WA 982478766
3609662106
Source: CMS National Downloadable File, September 2026.