Medical school: VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1986
NPI: 1518925015
Practice Locations (2)
5555 RESERVOIR DR, SUITE 208
San Diego, CA 921205187
5555 RESERVOIR DR, SUITE 208
SAN DIEGO, CA 921205187
6195837555
Source: CMS National Downloadable File, September 2026.