Medical school: RUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC)
Graduated: 2001
NPI: 1194713099
Practice Locations (1)
TEMPLE FACULTY PRACTICE PLAN INC
3322 N BROAD ST
PHILADELPHIA, PA 191405185
2107071800
Source: CMS National Downloadable File, September 2026.