| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1316985856 |
| License Number: | MD00039866 |
| License State: | WA |
| Medical School: | Angeles Univ Fndn, Coll Of Med, Angeles City, Pampanga, Philippines |
| Residency Training: | Lemuel Shattuck Hosp, Flexible Or Transitional Year |
| Graduation Year: | 1988 |