Graduated: 2011
NPI: 1457799652
Practice Locations (2)
SANFORD MEDICAL CENTER FARGO
1245 WASHINGTON AVE
DETROIT LAKES, MN 565013905
2188462000
SANFORD MEDICAL CENTER FARGO
4656 40TH AVE S, SUITE 130
FARGO, ND 581044397
7012342431
Source: CMS National Downloadable File, September 2026.