Medical school: GEISEL SCHOOL OF MEDICINE AT DARTMOUTH
Graduated: 2005
Offers telehealth
NPI: 1902006661
Practice Locations (1)
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
2121 SANTA MONICA BLVD
SANTA MONICA, CA 904042303
3108295511
Source: CMS National Downloadable File, September 2026.