Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 2002
NPI: 1932175767
Practice Locations (2)
6605 NANCY RIDGE DR
San Diego, CA 921212253
6605 NANCY RIDGE DR
SAN DIEGO, CA 921212253
Source: CMS National Downloadable File, September 2026.