Medical school: MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduated: 1996
Offers telehealth
NPI: 1003802570
Practice Locations (1)
PROMEDICA CENTRAL CORPORATION OF MICHIGAN
901 KIMOLE LN, SUITE A1
ADRIAN, MI 492211491
5172640590
Source: CMS National Downloadable File, September 2026.