Medical school: STATE UN OF NY, BUFFALO SCHOOL OF DENTAL MEDICINE
Graduated: 2025
NPI: 1457243719
Practice Locations (2)
25752 2ND STW, APT312
Zimmerman, MN 553987557
12628 FREMONT AVE
ZIMMERMAN, MN 553989735
Source: CMS National Downloadable File, September 2026.