| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1669567947 |
| License Number: | 35-048169 |
| License State: | OH |
| Medical School: | Med Coll Of Ohio, Toledo Oh 43699 |
| Residency Training: | Toledo Hosp, Family Medicine |
| Graduation Year: | 1981 |
| Certifications: | Family Practice; Occupational Medicine |