Medical school: WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1991
Also: CHIROPRACTIC, PREVENTIVE MEDICINE
NPI: 1558449165
Practice Locations (1)
PERMANENTE MEDICAL GROUP INC
801 TRAEGER AVE, SUITE 212
SAN BRUNO, CA 940663048
6507422000
Source: CMS National Downloadable File, September 2026.