Registry details
Type
Individual
Primary specialty
Anesthesiology
Enumerated
Dec 13, 2005
License(s)
187859 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 11914 ROSE HARBOR DR APT 310 | Tampa, FL 33625-5756 | 631-376-4088 |
| MAILING | 11914 ROSE HARBOR DR APT 310 | Tampa, FL 33625-5756 |
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