Registry details
Type
Individual
Primary specialty
Orthopaedic Surgery
Enumerated
May 14, 2020
License(s)
336311 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 44998 PAINE DR | Novi, MI 48377-2557 | 248-469-3935 |
| LOCATION | 1468 MADISON AVE | New York, NY 10029-6508 | 212-241-6500 |
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