Medical school: ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Graduated: 1999
NPI: 1871629170
Practice Locations (2)
12771 RIVERDALE BLVD NW, SUITE 103
COON RAPIDS, MN 554481263
12771 RIVERDALE NWBLVD, SUITE 103
COON RAPIDS, MN 554481263
Source: CMS National Downloadable File, September 2026.