Medical school: PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Graduated: 1989
NPI: 1457382822
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.