Medical school: GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1995
NPI: 1700876018
Practice Locations (3)
2555 HAMPSHIRE BLVD SE
Grand Rapids, MI 495064769
2555 HAMPSHIRE BLVD SE
GRAND RAPIDS, MI 495064769
17855 DALLAS PKWY, SUITE 200
DALLAS, TX 752876818
Source: CMS National Downloadable File, September 2026.