| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1023133451 |
| License Number: | MD00027446 |
| License State: | WA |
| Medical School: | Washington Univ Sch Of Med, St Louis Mo 63110 |
| Residency Training: | Univ Of Nd Sch Med & Hlth Sci, Family Practice |
| Graduation Year: | 1982 |