Medical school: MEDICAL COLLEGE OF WISCONSIN
Graduated: 1996
NPI: 1720010846
Practice Locations (2)
FAIRVIEW HEALTH SERVICES
201 E NICOLLET BLVD
BURNSVILLE, MN 553375714
9528922000
HEALTHEAST MEDICAL RESEARCH INSTITUTE
1575 BEAM AVE
MAPLEWOOD, MN 551091126
6512327000
Source: CMS National Downloadable File, September 2026.