Medical school: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated: 2024
NPI: 1811748791
Practice Locations (3)
PO BOX
MINNEAPOLIS, MN 55486
210 9TH ST SE
ROCHESTER, MN 559046756
MCHSMN PROVIDER ENROLLMENT, PO BOX 860912
ROCHESTER, MN 559050001
Source: CMS National Downloadable File, September 2026.