Medical school: MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduated: 2003
NPI: 1346360229
Practice Locations (1)
HENRY FORD SEMI MEDICAL GROUP
21000 E 12 MILE RD, SUITE 102
SAINT CLAIR SHORES, MI 480811156
8104475100
Source: CMS National Downloadable File, September 2026.