Graduated: 2006
NPI: 1164635306
Practice Locations (2)
UNIVERSITY OF PENN-MEDICAL GROUP
3400 SPRUCE ST
PHILADELPHIA, PA 191044206
UNIVERSITY OF PENN-MEDICAL GROUP
3400 SPRUCE STREET 5 WHITE BLDG, ORAL AND MAXILLOFACIAL SURGERY HUP
PHILADELPHIA, PA 191044206
2158296079
Source: CMS National Downloadable File, September 2026.