Gender: M

Race: C

Birth Date: 01/21/1933

Death Date: 10/04/1963

Place of Birth: Wichita Falls, TX

Year Medical License Issued: 1961

Medical School: Univ. TX Southwestern Medical School, Dallas

Medical School Location: TX

Degree: MD

Graduation Date: 1961

References:

Certified by TX Board?: Y

Location: Dallas

Specialty:

Secondary Specialty:

Notes: