Graduated: 2018
NPI: 1508361916
Practice Locations (2)
HENRY FORD HEALTH SYSTEM
2799 W GRAND BLVD
DETROIT, MI 482022608
3139162600
HENRY FORD HEALTH PROVIDENCE HOSPITAL
22250 PROVIDENCE DR, SUITE 202
SOUTHFIELD, MI 480756210
2488493281
Source: CMS National Downloadable File, September 2026.