Graduated: 2021
NPI: 1366015406
Practice Locations (2)
HENRY FORD HEALTH SYSTEM
2799 W GRAND BOULEVARD
DETROIT, MI 482022608
3139162600
W. A. FOOTE MEMORIAL HOSPITAL, INC.
205 N E AVE, HENRY FORD ALLEGIANCE HEALTH
JACKSON, MI 492011753
5172054800
Source: CMS National Downloadable File, September 2026.