Medical school: GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1995
NPI: 1518043512
Practice Locations (2)
1100 E MICHIGAN AVE, SUITE 202
JACKSON, MI 492011800
5177876210
1100 E MICHIGAN AVE, SUITE 202
JACKSON, MI 492011800
Source: CMS National Downloadable File, September 2026.