Medical school: UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Graduated: 1992
NPI: 1619038809
Practice Locations (1)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
1701 TWIN SPRINGS RD
HALETHORPE, MD 212273553
4107375000
Source: CMS National Downloadable File, September 2026.