Medical school: JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Graduated: 1984
NPI: 1114095981
Practice Locations (4)
12011 GOVERMENT CTR PKWY, SUITE 836
FAIRFAX, VA 220351100
12011 GOVERNMENT CTR PKWY, SUITE 836
FAIRFAX, VA 22035
12011 GOVERNMENT CTR PKWY, SUITE 836
FAIRFAX, VA 220351105
425 B CARLISLE DR
HERNDON, VA 201705618
Source: CMS National Downloadable File, September 2026.