Medical school: STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated: 1988
Also: PEDIATRIC MEDICINE
NPI: 1588830863
Practice Locations (1)
COUNTY OF SAN LUIS OBISPO
2191 JOHNSON AVE
SAN LUIS OBISPO, CA 934014534
5087815518
Source: CMS National Downloadable File, September 2026.