Medical school: MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduated: 1998
NPI: 1619959772
Practice Locations (5)
1 FORD PL
DETROIT, MI 482023067
1 FORD PL, SUITE 3A
DETROIT, MI 482023450
1717 SHAFFER ST, SUITE 2
KALAMAZOO, MI 490481623
26901 BEAUMONT BLVD
SOUTHFIELD, MI 480333849
100 MADISON AVENUE, S38805
TOLEDO, OH 436041516
Source: CMS National Downloadable File, September 2026.