Mississippi
Oktibbeha
Starkville
Family Medicine
surrendered
G75790
1991
medical activities:
patient care - 40+ hours
administration - 1 to 9 hours
license issued on December 28, 1992;
Ethnic background: caucasian/white/european/middle eastern
Loma Linda University School of Medicine (graduated in 1991)
5 YEARS of post graduate training
No affiliations
No associations
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Profile ID: FRUS-MDS-P-57372