Medical school: SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1996
NPI: 1962579037
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
700 2ND ST NE
WASHINGTON, DC 200028100
2023463000
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
14139 POTOMAC MILLS RD
WOODBRIDGE, VA 221924644
7032573000
Source: CMS National Downloadable File, September 2026.