Medical school: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1995
Offers telehealth
NPI: 1871821389
Practice Locations (1)
HENRY FORD SEMI MEDICAL GROUP
15300 W 9 MILE RD, 1 OAK PARK MEDICAL CENTER
OAK PARK, MI 482372585
2489682003
Source: CMS National Downloadable File, September 2026.