AMA Member: | No |
Gender: | Male |
National Provider Identifier (NPI): | 1578549812 |
License Number: | 5101010183 |
License State: | MI |
Medical School: | Kirksville College Of Osteopathic Medicine, Kirksville Mo 63501 |
Residency Training: | Maricopa Med Ctr, Psychiatry |
Graduation Year: | 1984 |