Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
Jul 5, 2005
License(s)
f2519 (TX), 20993 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1444 S 17TH ST | Wilmington, NC 28401-6436 | 910-793-4311 |
| MAILING | 1444 S 17TH ST | Wilmington, NC 28401-6436 | 910-793-4311 |
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