Medical school: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1992
NPI: 1255375846
Practice Locations (2)
8200 E JEFFERSON AVE, APT 1911
DETROIT, MI 482143932
15050 E JEFFERSON AVE, SUITE 104
GROSSE POINTE PARK, MI 482302050
3138224970
Source: CMS National Downloadable File, September 2026.