Medical school: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated: 1993
NPI: 1700811361
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
6551 LOISDALE CT
SPRINGFIELD, VA 221501828
7039221000
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
14139 POTOMAC MILLS RD
WOODBRIDGE, VA 221924644
7032573000
Source: CMS National Downloadable File, September 2026.