Graduated: 2018
NPI: 1205302999
Practice Locations (2)
NORTHERN LAKES SURGERY CENTER LLC
4791 COUNTY RD, SUITE 10
MOOSE LAKE, MN 557679221
2182495555
WELIA HEALTH
301 HWY 65 S
MORA, MN 550511899
3206791212
Source: CMS National Downloadable File, September 2026.