Medical school: HERMAN OSTROW SCHOOL OF DENTISTRY OF USC
Graduated: 2008
NPI: 1629234414
Practice Locations (1)
PROACTIVE PHYSICAL THERAPY AND SPORTS MEDICINE INC
6070 AVENIDA ENCINAS, SUITE 100
CARLSBAD, CA 920111001
7604440102
Source: CMS National Downloadable File, September 2026.