Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Jan 8, 2020
License(s)
24542 (NY), 024542-01 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | STRONG MEMORIAL HOSPITAL 601 ELMWOOD AVE | Rochester, NY 14642-0001 | 585-275-2100 |
| MAILING | 4005 EIGHT BELLES LN APT 2E | Greensboro, NC 27410-9874 | 607-423-9560 |
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