Medical school: WESTERN UNIVERSITY OF HEALTH SCIENCES COLLEGE OF DENTAL MED
Graduated: 2022
NPI: 1477297893
Practice Locations (1)
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
901 WILSHIRE BLVD, FL 1
SANTA MONICA, CA 904011854
3108298945
Source: CMS National Downloadable File, September 2026.