| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1063560134 |
| License Number: | 12167 |
| License State: | GA |
| Medical School: | Univ Of Mn Med Sch-Minneapolis, Minneapolis Mn 55455 |
| Residency Training: | Homewood Hosp Ctr-N Campus, General Surgery; Usphs Hosp, Flexible Or Transitional Year |
| Graduation Year: | 1961 |