Medical school: EASTERN VIRGINIA MEDICAL SCHOOL
Graduated: 2018
NPI: 1477041739
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
1221 MERCANTILE LN
LARGO, MD 207745374
3016185700
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
5999 BURKE COMMONS RD
BURKE, VA 220152880
7032497700
Source: CMS National Downloadable File, September 2026.