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Gender: M

Race: C

Birth Date: 1964

Death Date: 01/30/2004

Place of Birth: New Haven, CT

Year Medical License Issued:

Medical School: University of Texas

Medical School Location: TX

Degree: DP

Graduation Date: 1993

References: Obit: Houston Chronicle, 1/30/2004

Certified by TX Board?: N

Location:

Specialty:

Secondary Specialty:

Notes: