Graduated: 2016
NPI: 1013542182
Practice Locations (2)
SANFORD MEDICAL CENTER FARGO
4656 40TH AVE S
FARGO, ND 581044397
SANFORD MEDICAL CENTER FARGO
1220 SHEYENNE ST
WEST FARGO, ND 580782637
7012344445
Source: CMS National Downloadable File, September 2026.