Facts
- Status
- A
- Credential
- PharmD
- Type
- Individual
- Enumeration date
- 2019-08-15
- Last updated
- 2019-08-15
Licenses
- License MD
- 25645
Location
- Practice location
- 18924 MARSH HAWK LN
- City
- GAITHERSBURG MD
- Postal code
- 208791774
- Phone
- 240-855-1894
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.