Medical school: NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduated: 2009
NPI: 1679702567
Practice Locations (1)
THE SOUTHEAST PERMANENTE MEDICAL GROUP
3650 STEVE REYNOLDS BLVD
DULUTH, GA 300964506
7709316026
Source: CMS National Downloadable File, September 2026.