Medical school: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2025
NPI: 1013877943
Practice Locations (2)
15855 19 MILE RD, ATTN ENROLLMENT DEPT
Clinton Township, MI 480383504
15855 19 MILE RD
CLINTON TOWNSHIP, MI 480386324
Source: CMS National Downloadable File, September 2026.