Medical school: KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Graduated: 1996
NPI: 1679689764
Practice Locations (2)
654 MOUNT PROSPECT AVE, FL 3
NEWARK, NJ 071043110
9734827007
685 MOUNT PROSPECT AVE
NEWARK, NJ 071043151
9734827007
Source: CMS National Downloadable File, September 2026.