Medical school: PONCE SCHOOL OF MEDICINE
Graduated: 2000
NPI: 1205874591
Practice Locations (2)
FAIRVIEW SPECIALTY SERVICES
6405 FRANCE AVE S, SUITE W440
EDINA, MN 554352163
9528485600
FAIRVIEW EXPRESS CARE
14500 99TH AVE N, SUITE 100
MAPLE GROVE, MN 553694738
7638981000
Source: CMS National Downloadable File, September 2026.