Medical school: PERELMAN SCHOOL OF MED AT THE UNIVERSITY OF PENNSYLVANIA
Graduated: 1988
NPI: 1104805233
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.