| AMA Member: | No |
| Gender: | Male |
| National Provider Identifier (NPI): | 1780857474 |
| License Number: | A33069 |
| License State: | CA |
| Medical School: | Indiana University School Of Medicine, Indianapolis In 46202 |
| Residency Training: | Providence-Seattle Med Ctr, Internal Medicine |
| Graduation Year: | 1970 |
| Certifications: | Emergency Medicine |