Medical school: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2020
NPI: 1629682935
Practice Locations (2)
HENRY FORD HEALTH PROVIDENCE HOSPITAL
16001 W 9 MILE RD
SOUTHFIELD, MI 480754818
2488493000
NORTHSTAR ANESTHESIA OF MICHIGAN III PLLC
33155 ANNAPOLIS ST
WAYNE, MI 481842405
2146870001
Source: CMS National Downloadable File, September 2026.