Medical school: GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1979
Offers telehealth
NPI: 1275500233
Practice Locations (1)
CENTRACARE CLINIC
1555 NORTHWAY DR, 100 CENTRA CARE CLINIC NORTHWAY FAMILY
ST CLOUD, MN 563031258
3202511775
Source: CMS National Downloadable File, September 2026.