Medical school: MEDICAL COLLEGE OF PENNSYLVANIA
Graduated: 1981
NPI: 1841224102
Practice Locations (2)
14212 AMBAUM BLVD, SUITE 106
BURIEN, WA 981661437
14212 AMBAUM BLVD SW, SUITE 106
BURIEN, WA 981661437
2062445520
Source: CMS National Downloadable File, September 2026.