Medical school: NEW YORK COLLEGE OF PODIATRIC MEDICINE
Graduated: 2017
NPI: 1992258008
Practice Locations (1)
LAKESIDE MEDICAL ORGANIZATION A MEDICAL GROUP INC
191 S BUENA VISTA ST, SUITE 200 AND 240
BURBANK, CA 915054542
8188872671
Source: CMS National Downloadable File, September 2026.