New York
Office of the Professions
CHU WICO
Medicine (Physician, Including M Ds & D Os)
License number
181655
Date granted
03/09/1990
Date expires
05/31/2016
Class
Medicine (Physician, Including M Ds & D Os)
Status
Registered
Address
MIDDLETOWN NY
nymedicine.org
ID 30113888
LAST UPDATED 2026-04-13 09:43:47 UTC
LAST UPDATED 2026-04-13 09:43:47 UTC
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