Medical school: EASTERN VIRGINIA MEDICAL SCHOOL
Graduated: 2021
NPI: 1760061402
Practice Locations (1)
MAIN LINE HEALTHCARE
130 S BRYN MAWR AVE, MAIN LINE HEALTH PSYCHIATRIC ASSN PSYCH UNI
BRYN MAWR, PA 190103143
4843374286
Source: CMS National Downloadable File, September 2026.