Medical school: ALBANY MEDICAL COLLEGE OF UNION UNIVERSITY
Graduated: 2008
NPI: 1700049731
Practice Locations (2)
PROVIDENCE MEDICAL INSTITUTE
501 S BUENA VISTA ST
BURBANK, CA 915054809
8188473022
PROVIDENCE MEDICAL INSTITUTE
GLENDALE, CA 91202
Source: CMS National Downloadable File, September 2026.