Medical school: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduated: 1984
NPI: 1326166521
Practice Locations (2)
11633 SAN VICENTE BLVD, SUITE 106
Los Angeles, CA 900496512
11633 SAN VICENTE BLVD, SUITE 106
LOS ANGELES, CA 900496511
Source: CMS National Downloadable File, September 2026.