Medical school: MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduated: 1985
NPI: 1376520981
Practice Locations (1)
MEDSTAR MEDICAL GROUP II LLC
1145 19TH ST NW, 311 MMG AT 19TH STREET NW
WASHINGTON, DC 200363735
2024292401
Source: CMS National Downloadable File, September 2026.