Registry details
Type
Individual
Primary specialty
Physician Assistant, Surgical
Enumerated
Sep 11, 2008
License(s)
25MP00138700 (NJ), 9589 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 254 EASTON AVE ST PETERS UNIVERSITY HOSPITAL | New Brunswick, NJ 08901-1766 | 732-745-8600 |
| MAILING | 3000 HOSPITAL BLVD | Roswell, GA 30076-4915 | 770-664-9600 |
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