Medical school: ALBANY MEDICAL COLLEGE OF UNION UNIVERSITY
Graduated: 2004
NPI: 1619101102
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
700 2ND ST NE
WASHINGTON, DC 200028100
2023463000
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.