Medical school: YALE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1984
NPI: 1669583191
Practice Locations (2)
1501 OCTILLO DR G
EL CENTRO, CA 922274217
6194445917
3750 CONVOY ST, SUITE 116
SAN DIEGO, CA 921113739
8582921433110
Source: CMS National Downloadable File, September 2026.