Medical school: UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE
Graduated: 1996
NPI: 1487600987
Practice Locations (2)
2230 NW PETTYGROVE ST, SUITE 110
PORTLAND, OR 972102659
9712270560
MULTNOMAH COUNTY
900 N LOMBARD ST
PORTLAND, OR 972171346
5039885304
Source: CMS National Downloadable File, September 2026.