Medical school: LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduated: 2020
NPI: 1760002919
Practice Locations (1)
PROVIDENCE FACEY MEDICAL FOUNDATION
27924 SECO CANYON RD, SUITE 101
SANTA CLARITA, CA 913503854
6615132100
Source: CMS National Downloadable File, September 2026.