Medical school: PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 2023
NPI: 1467149070
Practice Locations (2)
PO, 1518 ATTN GOVERNMENT PAYER ENROLLMENT
Pasadena, CA 911101518
1608 S J ST, FL 3
TACOMA, WA 984054930
Source: CMS National Downloadable File, September 2026.