Medical school: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated: 2011
NPI: 1770874117
Practice Locations (2)
PARK NICOLLET CLINIC
5320 HYLAND GREENS DR
BLOOMINGTON, MN 554373934
9529932400
PARK NICOLLET CLINIC
14000 FAIRVIEW DR
BURNSVILLE, MN 553375713
9529938700
Source: CMS National Downloadable File, September 2026.