Medical school: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated: 1989
NPI: 1235195157
Practice Locations (2)
COUNTY OF SAN MATEO
22 W 39TH AVE, HOS316MS
SAN MATEO, CA 944034364
COUNTY OF SAN MATEO
222 W 39TH AVE
SAN MATEO, CA 944034364
Source: CMS National Downloadable File, September 2026.