Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1990
NPI: 1407830813
Practice Locations (1)
IHA OLMA SPECIALTY 1 LLC
19000 ST JOES PKWY, SUITE 210
LIVONIA, MI 481521477
7346558250
Source: CMS National Downloadable File, September 2026.