| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1386856896 |
| License Number: | G 58717 |
| License State: | CA |
| Medical School: | Univ Of Sc Sch Of Med, Columbia Sc 29208 |
| Residency Training: | Providence Med Ctr, Internal Medicine |
| Graduation Year: | 1985 |
| Certifications: | Public Health & General Preventive Medic |