Medical school: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated: 1997
NPI: 1114942216
Practice Locations (2)
LAKEWOOD HEALTH SYSTEM
49725 COUNTY, SUITE 83
Staples, MN 564795280
LAKEWOOD HEALTH SYSTEM
49725 COUNTY, SUITE 83
STAPLES, MN 564795280
2188941515
Source: CMS National Downloadable File, September 2026.