Medical school: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduated: 2000
NPI: 1477597128
Practice Locations (1)
DEPARTMENT OF STATE HOSPITALS
10333 EL CAMINO REAL, ATASCADERO STATE HOSPITAL
ATASCADERO, CA 934237001
9166518811
Source: CMS National Downloadable File, September 2026.