Graduated: 2021
NPI: 1790448504
Practice Locations (2)
ALLINA HEALTH SYSTEM
2925 CHICAGO AVE
MINNEAPOLIS, MN 554071321
6512627633
CENTRACARE CLINIC
3701 12TH ST N, SUITE 202
SAINT CLOUD, MN 563032253
3202583090
Source: CMS National Downloadable File, September 2026.