Medical school: MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduated: 2002
NPI: 1801968623
Practice Locations (2)
PERMANENTE MEDICAL GROUP INC
99 MONTECILLO RD
SAN RAFAEL, CA 949033308
4154442000
PERMANENTE MEDICAL GROUP INC
975 SERENO DR
VALLEJO, CA 945892441
7076511000
Source: CMS National Downloadable File, September 2026.