Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Apr 21, 2015
License(s)
32346 (OK), BP10052879/591971 (TX), 297731 (NY), 297731 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 550 1ST AVE | New York, NY 10016-6402 | 212-263-5313 |
| MAILING | 550 1ST AVE | New York, NY 10016-6402 |
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