| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1235121427 |
| License Number: | 5101011326 |
| License State: | MI |
| Medical School: | Mi State Univ Coll Of Human Med, East Lansing Mi 48824 |
| Graduation Year: | 1984 |
| Certifications: | Occupational Medicine |