Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Sep 14, 2006
License(s)
MA057401 (PA), C5-0011425 (DE)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 3401 BRANDYWINE PKWY STE 202 | Wilmington, DE 19803-1554 | 844-365-7246 |
| MAILING | 223 WILMINGTON W CHESTER PIKE STE 214 | Chadds Ford, PA 19317-9007 | 844-365-7246 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.