Medical school: MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Graduated: 2000
Offers telehealth
NPI: 1932124369
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES OREGON
200 S HAZEL DELL WAY
CANBY, OR 970137829
2032639500
Source: CMS National Downloadable File, September 2026.