| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1962412767 |
| License Number: | A88450 |
| License State: | CA |
| Medical School: | Univ Of Wa Sch Of Med, Seattle Wa 98195 |
| Residency Training: | Univ Of Wa Sch Of Med, General Surgery |
| Graduation Year: | 2001 |