Graduated: 2022
NPI: 1982570255
Practice Locations (3)
7101 YORK AVE S, SUITE 317
EDINA, MN 554354469
1370 MENDOTA HEIGHTS RD
MENDOTA HEIGHTS, MN 551201128
13890 MCKENNA RD NW
Prior Lake, MN 553797537
Source: CMS National Downloadable File, September 2026.