| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1710053020 |
| License Number: | 01032927A |
| License State: | IN |
| Medical School: | Oh State Univ Coll Of Med, Columbus Oh 43210 |
| Residency Training: | Riverside Methodist Hosp, Family Medicine; Miami Valley Hosp, Family Medicine |
| Graduation Year: | 1979 |
| Certifications: | Family Practice |