Medical school: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduated: 2001
NPI: 1336188580
Practice Locations (1)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
700 2ND ST NE
WASHINGTON, DC 200028100
2023463000
Source: CMS National Downloadable File, September 2026.