Registry details
Type
Individual
Primary specialty
Physician Assistant, Surgical
Enumerated
Sep 19, 2012
License(s)
015994 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 2209 GENESEE ST | Utica, NY 13501-5930 | 315-801-3329 |
| LOCATION | 2209 GENESEE ST | Utica, NY 13501-5930 | 315-801-3329 |
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