| NPI | 1396965919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN SEVERIN KRISTOFERSON President 940-382-6757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX F6842) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2018-08-20 |