AMA Member: | No |
Gender: | Male |
National Provider Identifier (NPI): | 1215018700 |
License Number: | E8271 |
License State: | TX |
Medical School: | Univ Airlangga, Fac Of Med, Surabaya, Jawa Timur, Indonesia |
Residency Training: | Austin State Hosp, Child & Adolescent Psychiatry; Austin State Hosp, Psychiatry; Santa Rosa Hlth Care Corp, Flexible Or Transitional Year |
Graduation Year: | 1965 |
Certifications: | Psychiatry |