Medical school: UNIV OF CALIF, LOS ANGELES SCHOOL OF DENTISTRY
Graduated: 1992
Also: ORAL SURGERY
NPI: 1255522793
Practice Locations (1)
UNIVERSITY OF PENN-MEDICAL GROUP
3400 CIVIC CTR BLVD 4TH FLOOR S, ORAL/MAXILL SURGERY PCAM
PHILADELPHIA, PA 191045127
2156623580
Source: CMS National Downloadable File, September 2026.