Medical school: PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 1997
NPI: 1972580405
Practice Locations (2)
1732 WYOMING AVE
FORTY FORT, PA 187044340
5703319134
200 S MEADE ST
WILKES BARRE, PA 187026221
5708236131
Source: CMS National Downloadable File, September 2026.