Registry details
Type
Individual
Primary specialty
Anesthesiology
Enumerated
Mar 23, 2016
License(s)
5101025600 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 401 W GREENLAWN AVE | Lansing, MI 48909 | 517-975-7888 |
| MAILING | 30039 WHITE HALL DR | Farmington Hills, MI 48331-1995 |
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