Graduated: 1997
NPI: 1710909353
Practice Locations (2)
SANFORD MEDICAL CENTER FARGO
2801 UNIVERSITY DR S
FARGO, ND 581036029
7012345673
SANFORD MEDICAL CENTER FARGO
1220 SHEYENNE ST
WEST FARGO, ND 580782637
7012344445
Source: CMS National Downloadable File, September 2026.