Medical school: UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated: 1978
NPI: 1477591105
Practice Locations (1)
HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC
30 PROSPECT AVE
HACKENSACK, NJ 076011915
5519965045
Source: CMS National Downloadable File, September 2026.