Medical school: PENNSYLVANIA COLLEGE OF OPTOMETRY
Graduated: 2007
NPI: 1104064583
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
1221 MERCANTILE LN
LARGO, MD 207745374
3016185700
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
10701 ROSEMARY DR
MANASSAS, VA 201097282
7032573000
Source: CMS National Downloadable File, September 2026.