Medical school: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2004
NPI: 1609084938
Practice Locations (1)
GRAND RIVER EMERGENCY MEDICAL GROUP PLC
200 JEFFERSON AVE SE, MERCY HEALTH ST. MARY'S
GRAND RAPIDS, MI 495034502
6166855000
Source: CMS National Downloadable File, September 2026.