Medical school: UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduated: 1980
Offers telehealth
NPI: 1255332268
Practice Locations (1)
HENRY FORD HEALTH PROVIDENCE HOSPITAL
30055 NORTHWESTERN HWY, SUITE 150
FARMINGTON HILLS, MI 483343211
2488654150
Source: CMS National Downloadable File, September 2026.