Graduated: 2016
NPI: 1467907147
Practice Locations (2)
CITY OF PHILADELPHIA
2230 COTTMAN AVE
PHILADELPHIA, PA 191491230
2156850602
CITY OF PHILADELPHIA
321 W GIRARD AVE, HEALTH CARE CTR 6
PHILADELPHIA, PA 191231531
2156853808
Source: CMS National Downloadable File, September 2026.