Medical school: KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Graduated: 1986
NPI: 1013912724
Practice Locations (2)
6704 PARK AVE
ALLEN PARK, MI 481012034
3133867920
VITAL PATH CARE PC
6704 PARK AVE
ALLEN PARK, MI 481012034
3133867920
Source: CMS National Downloadable File, September 2026.