Medical school: RUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC)
Graduated: 1987
NPI: 1609866946
Practice Locations (1)
TEMPLE FACULTY PRACTICE PLAN INC
3401 N BROAD ST
PHILADELPHIA, PA 191405103
2157075030
Source: CMS National Downloadable File, September 2026.