Medical school: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated: 1994
NPI: 1457342628
Practice Locations (2)
CENTRACARE CLINIC
3701 12TH ST N, SUITE 202
SAINT CLOUD, MN 563032253
3202583090
CENTRACARE CLINIC SOUTHWEST LLC
101 WILLMAR AVE SW
WILLMAR, MN 562013556
3202315000
Source: CMS National Downloadable File, September 2026.