Medical school: JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Graduated: 1977
NPI: 1700828472
Practice Locations (2)
2418 E ALLEGHENY AVE
Philadelphia, PA 191344403
2418 E ALLEGHENY AVE
PHILADELPHIA, PA 191344403
2156346660
Source: CMS National Downloadable File, September 2026.