Medical school: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1999
NPI: 1467554782
Practice Locations (2)
100 MICHIGAN ST NE, MC 845
GRAND RAPIDS, MI 495032551
1550 LARPENTEUR AVE W APT, SUITE 238
Falcon Heights, MN 551135015
Source: CMS National Downloadable File, September 2026.