Graduated: 1986
Offers telehealth
NPI: 1336259894
Practice Locations (3)
9811 MALLARD DR, SUITE 118
Laurel, MD 207083143
9811 MALLARD, SUITE 119
LAUREL, MD 207083143
3014979490
9811 MALLARD DR, SUITE 118 119
LAUREL, MD 207083143
Source: CMS National Downloadable File, September 2026.