Medical school: LAKE ERIE COL OF OSTEOPATHIC MEDICINE, BRADENTON
Graduated: 2014
NPI: 1144640269
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.