Graduated: 2017
NPI: 1659897353
Practice Locations (2)
SANFORD MEDICAL CENTER FARGO
21 WILEY AVE S
LIDGERWOOD, ND 580534001
7015384189
SANFORD MEDICAL CENTER FARGO
1220 SHEYENNE ST
WEST FARGO, ND 580782637
7012344445
Source: CMS National Downloadable File, September 2026.