Medical school: EMORY UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1993
NPI: 1457306763
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST
PORTLAND, OR 972132985
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 454
PORTLAND, OR 972132984
5032156405
Source: CMS National Downloadable File, September 2026.