Medical school: VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2022
NPI: 1386394872
Practice Locations (2)
393 E WALNUT ST FL, 3 PHR GROUP PROVIDER ENROLLMENT UNIT
Pasadena, CA 911880001
393 E WALNUT 3RD FL
PASEDENA, CA 911880001
Source: CMS National Downloadable File, September 2026.