Medical school: DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Graduated: 1997
NPI: 1750359915
Practice Locations (1)
GRAND ITASCA CLINIC AND HOSPITAL
1601 GOLF COURSE RD
GRAND RAPIDS, MN 557448648
2183263401
Source: CMS National Downloadable File, September 2026.