AMA Member: | Yes |
Gender: | Male |
National Provider Identifier (NPI): | 1649201344 |
License Number: | 1630391205 |
License State: | UT |
Medical School: | Case Western Reserve Univ Sch Of Med, Cleveland Oh 44106 |
Residency Training: | University Hosp, Psychiatry University Hosp, Flexible Or Transitional Year |
Graduation Year: | 1973 |