Medical school: NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduated: 2000
NPI: 1134148042
Practice Locations (2)
9892 BUSTLETON AVE
PHILADELPHIA, PA 191152184
9892 BUSTLETON AVE, SUITE 306
PHILADELPHIA, PA 191152140
2159690300
Source: CMS National Downloadable File, September 2026.