Medical school: PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 1976
Also: ALLERGY/IMMUNOLOGY
NPI: 1932107554
Practice Locations (1)
SOVEREIGN MEDICAL GROUP LLC
85 HARRISTOWN RD, SUITE 101
GLEN ROCK, NJ 074523323
2016709215
Source: CMS National Downloadable File, September 2026.