| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1043307945 |
| License Number: | RM054137 |
| License State: | MI |
| Medical School: | George Washington Univ Sch Of Med & Hlth Sci, Washington Dc 20037 |
| Residency Training: | Oregon State Hosp, Psychiatry; Legacy Emmanuel Hosp & Med Ctr, Flexible Or Transitional Year |
| Graduation Year: | 1965 |