| AMA Member: | No |
| Gender: | Male |
| National Provider Identifier (NPI): | 1306921812 |
| License Number: | R7J70 |
| License State: | MO |
| Medical School: | Des Moines Univ, Coll Osteo Med & Surg, Des Moines Ia 50312 |
| Residency Training: | Univ Hosp-Suny Stony Brook, Psychiatry |
| Graduation Year: | 1985 |