Medical school: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2000
NPI: 1780773549
Practice Locations (2)
1710 E 12 MILE RD
ROYAL OAK, MI 480734200
1710 E 12 MILE RD, SUITE 102
ROYAL OAK, MI 480734200
2489302137
Source: CMS National Downloadable File, September 2026.