Medical school: MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduated: 1998
NPI: 1699744953
Practice Locations (2)
THEORIA MEDICAL
288 PEACE BLVD
SAINT JOSEPH, MI 490859562
2695569050
LAKELAND COMMUNITY HOSPITAL WATERVLIET
400 MEDICAL PARK DR
WATERVLIET, MI 490989225
2694633600
Source: CMS National Downloadable File, September 2026.