Graduated: 2016
NPI: 1841645298
Practice Locations (2)
PINE MEDICAL CENTER
45 LADY LUCK DR
HINCKLEY, MN 550376419
3202798600
ESSENTIA HEALTH MOOSE LAKE
4572 COUNTY RD, SUITE 61
MOOSE LAKE, MN 557679401
2184852105
Source: CMS National Downloadable File, September 2026.