| AMA Member: | No |
| Gender: | Male |
| National Provider Identifier (NPI): | 1508843335 |
| License Number: | 38367 |
| License State: | MN |
| Medical School: | Tulane University School of Medicine, New Orleans, LA, 1993 |
| Residency Training: | Regions Hosp, General Preventive Medicine; Madigan Army Med Ctr, Flexible Or Transitional Year |
| Graduation Year: | 1989 |
| Certifications: | Occupational Medicine |