Medical school: UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduated: 1966
NPI: 1437195013
Practice Locations (2)
22050 PROVIDENCE DR, SUITE 402
SOUTHFIELD, MI 480756212
2485593150
22250 PROVIDENCE DR, SUITE 402
SOUTHFIELD, MI 480756212
Source: CMS National Downloadable File, September 2026.