Medical school: ALBANY MEDICAL COLLEGE OF UNION UNIVERSITY
Graduated: 2005
NPI: 1871785501
Practice Locations (1)
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
2001 SANTA MONICA BLVD, SUITE 970W
SANTA MONICA, CA 904042199
3108297878
Source: CMS National Downloadable File, September 2026.