Medical school: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduated: 1999
NPI: 1720185382
Practice Locations (1)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
13652 CANTARA ST
PANORAMA CITY, CA 914025423
8183752000
Source: CMS National Downloadable File, September 2026.