Medical school: TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Graduated: 2001
NPI: 1417072745
Practice Locations (1)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
7141 SECURITY BLVD, WOODLAWN MED CTR
BALTIMORE, MD 212441811
4436636000
Source: CMS National Downloadable File, September 2026.