Medical school: UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduated: 2011
NPI: 1407111206
Practice Locations (3)
2381 ROSECRANS AVE, SUITE 115
EL SEGUNDO, CA 902454920
PHR GROUP PROVIDER ENROLLMENT UNIT 3RD FL, 393 E WALNUT STREET
PASADENA, CA 911880001
5080 SPECTRUM DR, SUITE 1200W
ADDISON, TX 750016443
Source: CMS National Downloadable File, September 2026.