| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1093741803 |
| License Number: | MD25028 |
| License State: | OR |
| Medical School: | New York Medical College, Valhalla Ny 10595 |
| Residency Training: | Usuhs F E Hebert Sch Of Med, General Preventive Medicine; Madigan Army Med Ctr, Internal Medicine |
| Graduation Year: | 1997 |