Medical school: UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduated: 1986
NPI: 1205056967
Practice Locations (2)
555 S OLD WOODWARD, SUITE 602
BIRMINGHAM, MI 480096615
555 S OLD WOODWARD AVE
BIRMINGHAM, MI 480096615
2485946330248594
Source: CMS National Downloadable File, September 2026.