Graduated: 2008
NPI: 1760920482
Practice Locations (4)
1900 E NORTHERN PKWY
BALTIMORE, MD 212392113
1900 E NORTHERN PKWY, SUITE 201
BALTIMORE, MD 212392110
PO BOX, SUITE 29265
BALTIMORE, MD 21205
4134 KENNYGREEN CT
RANDALLSTOWN, MD 211335302
Source: CMS National Downloadable File, September 2026.