Medical school: PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated: 1999
NPI: 1174583314
Practice Locations (2)
129 S SPARKS ST, APT 5
STATE COLLEGE, PA 168013913
8142720818
500 W 3RD ST
WILLIAMSPORT, PA 177016010
5703228448
Source: CMS National Downloadable File, September 2026.