Graduated: 1988
NPI: 1497723548
Practice Locations (2)
UNIVERSITY OF PENN-MEDICAL GROUP
3400 SPRUCE ST
PHILADELPHIA, PA 191044238
2153498310
TEMPLE FACULTY PRACTICE PLAN INC
3401 N BROAD ST
PHILADELPHIA, PA 191405103
2157073008
Source: CMS National Downloadable File, September 2026.