Medical school: UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE
Graduated: 2012
NPI: 1164775441
Practice Locations (3)
LEGACY MEDICAL LLC
4195 WESTBERG RD, APT 436
HERMANTOWN, MN 558113888
7015164637
LEGACY MEDICAL LLC
4420 37TH AVE S, SUITE 1
FARGO, ND 581043400
7015164637
LEGACY PRIMARY CARE PLLC
2100 S COLUMBIA RD, SUITE 114
GRAND FORKS, ND 582015895
7015164637
Source: CMS National Downloadable File, September 2026.