Medical school: MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduated: 1999
NPI: 1871516294
Practice Locations (4)
PO BOX
CHICAGO, IL 60677
200 JEFFERSON AVE SE
GRAND RAPIDS, MI 495034502
1077 GORGE BLVD
AKRON, OH 443102408
CVO PAYER ENROLLMENT, 1077 GORGE BLVD
AKRON, OH 443102408
Source: CMS National Downloadable File, September 2026.