Medical school: SOUTHERN ILLINOIS UNIV SCHOOL OF DENTAL MEDICINE
Graduated: 2004
NPI: 1295902096
Practice Locations (2)
HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC
16 JOHNSON AVE
HACKENSACK, NJ 076014818
2013427353
HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC
30 PROSPECT AVE
HACKENSACK, NJ 076011915
Source: CMS National Downloadable File, September 2026.