| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1740325992 |
| License Number: | 20351 |
| License State: | TN |
| Medical School: | New York Medical College, Valhalla Ny 10595 |
| Residency Training: | Tripler Army Med Ctr, General Surgery; Madigan Army Med Ctr, General Surgery |
| Graduation Year: | 1982 |
| Certifications: | Surgery |