Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1995
NPI: 1831160274
Practice Locations (1)
ST CLOUD PATHOLOGISTS PA
1900 CENTRACARE CIR
SAINT CLOUD, MN 563035000
320251270057309
Source: CMS National Downloadable File, September 2026.