Medical school: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduated: 1981
Offers telehealth
NPI: 1578590659
Practice Locations (1)
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
901 WILSHIRE BLVD, FL 3
SANTA MONICA, CA 904011854
3108298903
Source: CMS National Downloadable File, September 2026.