Graduated: 1997
NPI: 1225447766
Practice Locations (3)
22101 MOROSS RD
DETROIT, MI 482362148
3133434000
GREAT LAKES MEDICAL GROUP PC
19070 E 10 MILE RD
EASTPOINTE, MI 480211449
5867731383
HENRY FORD HEALTH PROVIDENCE HOSPITAL
22250 PROVIDENCE DR, SUITE 301A
SOUTHFIELD, MI 480756211
2488493281
Source: CMS National Downloadable File, September 2026.