| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1881719615 |
| License Number: | 13554 |
| License State: | AZ |
| Medical School: | Univ Of Az Coll Of Med, Tucson Az 85724 |
| Residency Training: | Tucson Med Ctr, Flexible Or Transitional Year |
| Graduation Year: | 1981 |