Medical school: PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 1995
NPI: 1275513814
Practice Locations (1)
WELLSPAN MEDICAL GROUP
30 N 4TH ST, 2 WELLSPAN FAMILY MEDICINE NORTH FOURTH STR
LEBANON, PA 170465606
7172722940
Source: CMS National Downloadable File, September 2026.