Medical school: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2004
NPI: 1841339108
Practice Locations (4)
1 CITY BLVD W, SUITE 1100
ORANGE, CA 928683647
PO BOX
PORTLAND, OR 97208
700 NE 87TH AVE
Vancouver, WA 986641913
700 NE 87TH AVE
VANCOUVER, WA 986641913
Source: CMS National Downloadable File, September 2026.