Registry details
Type
Individual
Primary specialty
Anesthesiology
Enumerated
Oct 12, 2020
License(s)
7394320 (WI), 4301513867 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2799 W GRAND BLVD | Detroit, MI 48202-2608 | 313-916-2600 |
| MAILING | 20820 LITTLESTONE RD APT 5 | Harper Woods, MI 48225-2333 | 313-207-2302 |
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