Medical school: WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1999
NPI: 1841377785
Practice Locations (2)
PERMANENTE MEDICAL GROUP INC
700 LAWRENCE EXPY
SANTA CLARA, CA 950515173
4088511000
PERMANENTE MEDICAL GROUP INC
710 LAWRENCE EXPRESS WAY
SANTA CLARA, CA 950515173
4088511000
Source: CMS National Downloadable File, September 2026.