Medical school: AT STILL UN OF HLTH SCIENCES, COL OF OSTEO MED, MESA
Graduated: 2023
NPI: 1437843828
Practice Locations (1)
ACTIVEPT, CORP.
3708 BROADWAY AVE N, SUITE 110
ROCHESTER, MN 559064159
5073223460
Source: CMS National Downloadable File, September 2026.