Medical school: UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated: 1996
Offers telehealth
NPI: 1972588531
Practice Locations (1)
PARK NICOLLET CLINIC
5320 HYLAND GREENS DR
BLOOMINGTON, MN 554373934
9529932400
Source: CMS National Downloadable File, September 2026.