Graduated: 2008
NPI: 1669636080
Practice Locations (2)
TEMPLE FACULTY PRACTICE PLAN INC
3401 N BROAD ST
PHILADELPHIA, PA 191405103
2157075030
GEISINGER CLINIC
1000 E MOUNTAIN DR
WILKES BARRE, PA 187110027
5708267300
Source: CMS National Downloadable File, September 2026.