AMA Member: | Yes |
Gender: | Male |
National Provider Identifier (NPI): | 1023128287 |
License Number: | 26148 |
License State: | NC |
Medical School: | Univ Padjadjaran, Fac Of Med, Bandung, Jawa Barat, Indonesia |
Residency Training: | Bowman Gray Sch Med Afl Hs, Neurology; Washington Hosp Ctr, General Surgery |
Graduation Year: | 1971 |