Medical school: SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1999
Offers telehealth
NPI: 1669481040
Practice Locations (1)
HENNEPIN HEALTHCARE SYSTEM INC
2215 E LAKE ST, SUITE 500
MINNEAPOLIS, MN 554074385
6128736963
Source: CMS National Downloadable File, September 2026.