| AMA Member: | No |
| Gender: | Male |
| National Provider Identifier (NPI): | 1245455096 |
| License Number: | 1660581205 |
| License State: | UT |
| Medical School: | Univ Of Ut Sch Of Med, Salt Lake Cty Ut 84132 |
| Residency Training: | Wm Beaumont Hosp, General Surgery |
| Graduation Year: | 1978 |