| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1073687612 |
| License Number: | 57584271205 |
| License State: | UT |
| Medical School: | East Carolina Univ Sch Of Med, Greenville Nc 27858 |
| Residency Training: | Good Samaritan Reg Med Ctr, Family Medicine |
| Graduation Year: | 1986 |
| Certifications: | Family Practice |