Medical school: UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Graduated: 1999
NPI: 1639361421
Practice Locations (1)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
5601 DE SOTO AVE
WOODLAND HILLS, CA 913676701
8187192000
Source: CMS National Downloadable File, September 2026.