Graduated: 2021
NPI: 1598417305
Practice Locations (2)
HENRY FORD HEALTH PROVIDENCE HOSPITAL
16001 W 9 MILE RD
SOUTHFIELD, MI 480754818
2488493000
HENRY FORD WYANDOTTE HOSPITAL
2333 BIDDLE AVE
WYANDOTTE, MI 481924668
Source: CMS National Downloadable File, September 2026.