Graduated: 1985
NPI: 1720259153
Practice Locations (2)
ACTIVE THERAPY MN
10300 HENNEPIN TOWN RD
EDEN PRAIRIE, MN 553475100
7327038504
AEGIS GROUP PRACTICE LLC
5601 94TH AVE N
MINNEAPOLIS, MN 554432395
7634012461
Source: CMS National Downloadable File, September 2026.