Medical school: OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1997
NPI: 1073592408
Practice Locations (2)
100 MICHIGAN ST NE, MC 845
GRAND RAPIDS, MI 495032551
100 MICHIGAN ST NE MC, SUITE 845
GRAND RAPIDS, MI 495032560
Source: CMS National Downloadable File, September 2026.