| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1881852622 |
| License Number: | 27263 |
| License State: | KY |
| Medical School: | Southern Il Univ Sch Of Med, Springfield Il 62794 |
| Residency Training: | Methodist Med Ctr Il, Family Practice |
| Graduation Year: | 1984 |