Medical school: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated: 2006
NPI: 1598797896
Practice Locations (2)
ST MARYS REGIONAL HEALTH CENTER
1027 WASHINGTON AVE
DETROIT LAKES, MN 565013409
2188475611
INNOVIS HEALTH LLC
3000 32ND AVE S
FARGO, ND 581036132
7013648000
Source: CMS National Downloadable File, September 2026.