Medical school: MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduated: 2012
Offers telehealth
NPI: 1760744478
Practice Locations (1)
GRAND ITASCA CLINIC AND HOSPITAL
1601 GOLF COURSE RD
GRAND RAPIDS, MN 557448648
2183263401
Source: CMS National Downloadable File, September 2026.