Medical school: UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
Graduated: 1996
Offers telehealth
NPI: 1942317987
Practice Locations (1)
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
2121 SANTA MONICA BLVD
SANTA MONICA, CA 904042303
3108295511
Source: CMS National Downloadable File, September 2026.