Medical school: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Graduated: 1998
NPI: 1023158425
Practice Locations (1)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
4920 CAMPBELL BLVD
NOTTINGHAM, MD 212365916
4109337600
Source: CMS National Downloadable File, September 2026.