Medical school: EDWARD VIA COL OF OSTEO MEDICINE-CAROLINAS CAMPUS
Graduated: 2018
NPI: 1710483862
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
12255 FAIR LAKES PKWY
FAIRFAX, VA 220333952
7032374800
Source: CMS National Downloadable File, September 2026.