| NPI | 1396143392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WADE C VAN SICE Physician/Surgeon 504-615-6325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: FL ME122314) |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2014-12-08 |