Medical school: PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 1991
NPI: 1366673097
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
110 IRVING ST NW
WASHINGTON, DC 200103017
2028779875
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
815 E PRATT ST, BHMC
BALTIMORE, MD 212024402
4106375700
Source: CMS National Downloadable File, September 2026.