Medical school: UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated: 1993
Also: ORAL SURGERY
NPI: 1356559876
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.