Medical school: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated: 2002
NPI: 1588764039
Practice Locations (2)
ST CLOUD HOSPITAL
1406 6TH AVE N
SAINT CLOUD, MN 563031900
3202512700
ST CLOUD HOSPITAL
110 2ND ST S, SUITE 104
WAITE PARK, MN 563871367
3202599375
Source: CMS National Downloadable File, September 2026.