| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1013196260 |
| License Number: | 4301052893 |
| License State: | MI |
| Medical School: | Mi State Univ Coll Of Human Med, East Lansing Mi 48824 |
| Residency Training: | L A Co-Usc Med Ctr, Child & Adolescent Psychiatry; L A Co-Usc Med Ctr, Psychiatry; Mi St U Coll Human Med-Flint, Diagnostic Radiology; Henry Ford Hosp, Flexible Or Transitional Year |
| Graduation Year: | 1988 |