| AMA Member: | No |
| Gender: | Male |
| National Provider Identifier (NPI): | 1912910340 |
| License Number: | 12320 |
| License State: | OK |
| Medical School: | Univ Of Ok Coll Of Med, Oklahoma City Ok 73190 |
| Residency Training: | Univ Ok Hlth Sci Ctr, Flexible Or Transitional Year |
| Graduation Year: | 1978 |