Medical school: COLLEGE OF OSTEO MED OF THE PACIFIC AT POMONA
Graduated: 1996
NPI: 1689617110
Practice Locations (1)
AQUA DERMATOLOGY OF FLORIDA, PA
25987 S TAMIAMI TRL, SUITE 90
BONITA SPRINGS, FL 341347810
2394443201
Source: CMS National Downloadable File, September 2026.