Gender: M

Race: C

Birth Date: 09/20/1929

Death Date: 04/13/1969

Place of Birth: Oklahoma City, OK

Year Medical License Issued: 1957

Medical School: Univ. Texas Southwestern Medical School, Dallas

Medical School Location: TX

Degree: MD

Graduation Date: 1957

References:

Certified by TX Board?: Y

Location:

Specialty:

Secondary Specialty:

Notes: