| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1053338913 |
| License Number: | 37732 |
| License State: | MN |
| Medical School: | Univ Of Mn Med Sch-Minneapolis, Minneapolis Mn 55455 |
| Residency Training: | Luther Hosp, Family Medicine |
| Graduation Year: | 1992 |
| Certifications: | Family Practice |