Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Aug 16, 2019
License(s)
PA9112261 (FL), MA064618 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 200 LOTHROP ST | Pittsburgh, PA 15213-2536 | 412-647-2345 |
| MAILING | 6308 WHITEWAY DR | Temple Terrace, FL 33617-3109 | 813-403-2074 |
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