| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1629107131 |
| License Number: | MD26570 |
| License State: | OR |
| Medical School: | Univ Of Miami Sch Of Med, Miami Fl 33101 |
| Residency Training: | Exempla St Joseph Hosp, Internal Medicine |
| Graduation Year: | 1975 |