Medical school: BAYLOR COLLEGE OF MEDICINE
Graduated: 1994
Offers telehealth
NPI: 1396761482
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES OREGON
18040 SW LOWER BOONES FERRY RD, SUITE 207
TIGARD, OR 972247259
5035375900
Source: CMS National Downloadable File, September 2026.