Medical school: EASTERN VIRGINIA MEDICAL SCHOOL
Graduated: 1995
NPI: 1073568648
Practice Locations (2)
SANFORD MEDICAL CENTER FARGO
4000 28TH AVE S
MOORHEAD, MN 565607926
7012343200
SANFORD MEDICAL CENTER FARGO
5225 23RD AVE S
FARGO, ND 581047927
7014172575
Source: CMS National Downloadable File, September 2026.