Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Oct 25, 2006
License(s)
5601003626 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2799 W GRAND BLVD HYPERTENSION/NEPHROLOGY | Detroit, MI 48202-2608 | 248-835-6400 |
| MAILING | 2801 BAMLET RD | Royal Oak, MI 48073-2980 | 248-224-4720 |
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