Graduated: 2024
NPI: 1639057441
Practice Locations (3)
12225 28TH ST N, SUITE A
ST PETERSBURG, FL 337161860
115 DELAWARE AVE
GLEN BURNIE, MD 210613013
1190 WINTERSON RD, SUITE 200
LINTHICUM, MD 210902245
Source: CMS National Downloadable File, September 2026.