Medical school: RUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC)
Graduated: 1995
NPI: 1790717007
Practice Locations (1)
UNIVERSITY OF PENN-MEDICAL GROUP
3400 CIVIC CTR BLVD
PHILADELPHIA, PA 191045127
2156622428
Source: CMS National Downloadable File, September 2026.