| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1255431813 |
| License Number: | 01063838A |
| License State: | IN |
| Medical School: | Indiana University School Of Medicine, Indianapolis In 46202 |
| Residency Training: | Clarian Indiana Univ Hosp, General Surgery |
| Graduation Year: | 1983 |
| Certifications: | Occupational Medicine |