| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1447371828 |
| License Number: | C33501 |
| License State: | CA |
| Medical School: | Oh State Univ Coll Of Med, Columbus Oh 43210 |
| Residency Training: | La Co Harbor Ucla Med Ctr, Flexible Or Transitional Year |
| Graduation Year: | 1970 |