Medical school: WESTERN UN OF HLTH SCIENCES, COL OF PODIATRIC MED
Graduated: 2022
NPI: 1891424859
Practice Locations (2)
393 E WALNUT ST FL, 3 PHR GROUP PROVIDER ENROLLMENT UNIT
Pasadena, CA 911880001
393 E WALNUT 3RD FL
PASEDENA, CA 911880001
Source: CMS National Downloadable File, September 2026.