Graduated: 2020
NPI: 1780211656
Practice Locations (4)
400 MACK AVE
DETROIT, MI 482012136
26901 BEAUMONT BLVD
SOUTHFIELD, MI 480333849
29201 TELEGRAPH RD, SUITE 324
SOUTHFIELD, MI 480341300
8 QUAIL PATH
Glen Head, NY 115452923
Source: CMS National Downloadable File, September 2026.