Gender: M

Race: C

Birth Date: 02/22/1932

Death Date: 11/26/1966

Place of Birth: Fort Worth, TX

Year Medical License Issued: 1960

Medical School: Univ. TX Medical Branch, Galveston

Medical School Location: TX

Degree: MD

Graduation Date: 1960

References: Jr.

Certified by TX Board?: Y

Location: Fort Worth

Specialty: Preventive Medicine

Secondary Specialty:

Notes: