Medical school: LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1980
NPI: 1497740930
Practice Locations (2)
1179 E PARIS AVE SE, SUITE 100
GRAND RAPIDS, MI 495463682
6164005433
847 PARCHMENT DR SE, SUITE 120
GRAND RAPIDS, MI 495462377
6169138441
Source: CMS National Downloadable File, September 2026.