Born in Argentina completed studies including medical school and residency there. Came to the US in 1975, did 4 additional years of residency training at the University of Chicago, became a faculty member at University of California San Francisco (1979-1992). Recruited to University of Washington as The Henry N. Harkins Professor and Chair, Department of Surgery (1993-2015). Developed the Center for Laparoscopic Surgery, the Simulation Center and the Center for Esophageal Surgery during this tenure. Became Chief Medical Officer, UW Medicine and Vice President Medical Affairs University of Washington 2015-2019. Elected President of the American Surgical Association (2005-2006) and the American College of Surgeons (2013-2014). Member of the Board of The Joint Commission and vice-chair of that board 2020-2022.