Medical school: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduated: 2006
NPI: 1629236039
Practice Locations (1)
PERMANENTE MEDICAL GROUP INC
401 BICENTENNIAL WAY
SANTA ROSA, CA 954032149
7073934000
Source: CMS National Downloadable File, September 2026.