| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1619173754 |
| License Number: | M-5516 |
| License State: | ID |
| Medical School: | Bowman Gray Sch Of Med Of Wake Forest Univ, Winston-Salem Nc 27157 |
| Residency Training: | Usaf Sch Aerospace Med, Aerospace Medicine; Baptist Hosp, Flexible Or Transitional Year |
| Graduation Year: | 1962 |
| Certifications: | Aerospace Medicine |