Graduated: 1982
Offers telehealth
NPI: 1518035732
Practice Locations (2)
REVIVED SOUL MEDICAL PC
1329 E 17TH ST
BROOKLYN, NY 112306052
7183825060
KLAMATH HEALTH PARTNERSHIP INC
2074 S 6TH ST
KLAMATH FALLS, OR 976013372
5418802011
Source: CMS National Downloadable File, September 2026.