Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
Oct 2, 2020
License(s)
MTL005859 (DC), 94-11289 (KS)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 4000 CAMBRIDGE ST | Kansas City, KS 66160-8501 | 913-588-0844 |
| MAILING | 6550 FANNIN ST STE SM1801 | Houston, TX 77030-2717 | 713-441-3625 |
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