Medical school: WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2025
NPI: 1609764034
Practice Locations (2)
150 E 42ND STREET 5TH FLOOR
New York, NY 100175669
150 E 42ND STREET 9TH FLOOR
NEW YORK, NY 100175669
Source: CMS National Downloadable File, September 2026.