Graduated: 1994
NPI: 1306944061
Practice Locations (2)
HENRY FORD HEALTH ST. JOHN HOSPITAL
22101 MOROSS RD
DETROIT, MI 482362148
3133434000
HENRY FORD HEALTH ST. JOHN HOSPITAL
21000 E 12 MILE RD
SAINT CLAIR SHORES, MI 480811116
5864475000
Source: CMS National Downloadable File, September 2026.