| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1265490247 |
| License Number: | MD00043875 |
| License State: | WA |
| Medical School: | Or Hlth Sci Univ Sch Of Med, Portland Or 97201 |
| Residency Training: | Providence Hosp, Family Medicine |
| Graduation Year: | 2001 |