Graduated: 2020
NPI: 1376212761
Practice Locations (3)
HENNEPIN COUNTY
1009 E 14TH ST
MINNEAPOLIS, MN 554041314
6123485553
1516 E LAKE ST, SUITE 1512
MINNEAPOLIS, MN 554071720
6123454929
HENNEPIN COUNTY
165 GLENWOOD AVE
MINNEAPOLIS, MN 554051618
6123485553
Source: CMS National Downloadable File, September 2026.