Medical school: PENNSYLVANIA COLLEGE OF OPTOMETRY
Graduated: 1988
NPI: 1760558902
Practice Locations (3)
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
43480 YUKON DR, SUITE 100
ASHBURN, VA 201476988
5712526000
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.