| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1912071945 |
| License Number: | 4301077276 |
| License State: | MI |
| Medical School: | Wayne State Univ Sch Of Med, Detroit Mi 48201 |
| Residency Training: | Beth Israel Med Ctr, Family Medicine |
| Graduation Year: | 1996 |
| Certifications: | Family Practice |