Registry details
Type
Individual
Primary specialty
Anesthesiology, Pain Medicine
Enumerated
Sep 13, 2010
License(s)
2011-01487 (NC), 33814 (SC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 6429 BANNINGTON RD SUITE B | Charlotte, NC 28226-1344 | 704-503-9338 |
| LOCATION | 6429 BANNINGTON RD STE B | Charlotte, NC 28226-1345 | 704-503-9338 |
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