Medical school: MEDICAL COLLEGE OF WISCONSIN
Graduated: 2022
Offers telehealth
NPI: 1174269815
Practice Locations (2)
PARK NICOLLET CLINIC
5320 HYLAND GREENS DR
BLOOMINGTON, MN 554373934
9529932400
PARK NICOLLET CLINIC
12142 BUSINESS PARK BLVD N
CHAMPLIN, MN 553164525
9529770500
Source: CMS National Downloadable File, September 2026.