Medical school: UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduated: 2016
NPI: 1053765123
Practice Locations (1)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
1701 TWIN SPRINGS RD
HALETHORPE, MD 212273553
4107375000
Source: CMS National Downloadable File, September 2026.