Medical school: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated: 1999
NPI: 1740346733
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
2391 GREENSPRING DR
TIMONIUM, MD 210936038
3018162424
Source: CMS National Downloadable File, September 2026.