Graduated: 2001
NPI: 1871629964
Practice Locations (2)
TRIA ORTHOPAEDIC CENTER LLC
8100 NORTHLAND DR
BLOOMINGTON, MN 554314800
9528318742
PARK NICOLLET CLINIC
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 554264702
9529933123
Source: CMS National Downloadable File, September 2026.