Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Sep 30, 2016
License(s)
025065 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1100 WILFORD HALL LOOP | Lackland Afb, TX 78236-5638 | 210-292-4277 |
| LOCATION | 1100 WILFORD HALL LOOP | Lackland Afb, TX 78236-5638 | 210-292-4277 |
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