Medical school: WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2015
NPI: 1649667965
Practice Locations (4)
1500 SAN PABLO ST
Los Angeles, CA 900335313
1510 COTNER AVE
LOS ANGELES, CA 900253303
PHR GROUP PROVIDER ENROLLMENT UNIT
PASADENA, CA 911880001
1150 G PITTSFORD-VICTOR RD
PITTSFORD, NY 145343818
Source: CMS National Downloadable File, September 2026.