Medical school: NEW YORK MEDICAL COLLEGE
Graduated: 2011
Offers telehealth
NPI: 1902190820
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES OREGON
9290 SE SUNNYBROOK BLVD, SUITE 120
CLACKAMAS, OR 970156802
5032152110
Source: CMS National Downloadable File, September 2026.