| AMA Member: | Yes |
| Gender: | Male |
| National Provider Identifier (NPI): | 1083779904 |
| License Number: | 1046449 |
| License State: | IN |
| Medical School: | Va Commonwealth Univ, Med Coll Of Va Sch Of Med, Richmond Va 23298 |
| Residency Training: | Usaf Sch Aerospace Med, Aerospace Medicine; Univ Of Wa Sch Pub Hlth, General Preventive Medicine; Med Coll Of Ga Hosp & Cli, Flexible Or Transitional Year |
| Graduation Year: | 1969 |
| Certifications: | General Preventive Medicine |