Medical school: JC EDWARDS SCHOOL OF MEDICINE, MARSHALL UNIVERSITY
Graduated: 1995
NPI: 1326080649
Practice Locations (2)
PHS INDIAN HOSPITAL
PO BOX, SUITE 497
RED LAKE, MN 566710497
PHS INDIAN HOSPITAL
24760 HOSPITAL DR
REDLAKE, MN 566710497
2186793912108
Source: CMS National Downloadable File, September 2026.