Medical school: KANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
Graduated: 1981
NPI: 1619050762
Practice Locations (2)
8120 PENN AVE S, SUITE 440
BLOOMINGTON, MN 554311326
9529200844
8120 PENN S AVE, SUITE 440
BLOOMINGTON, MN 55431
Source: CMS National Downloadable File, September 2026.