| NPI | 1447224779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIDYA DORAISWAMY Credentialing Specilaist 954-680-2108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery Hand Surgery |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine | |
| 207XX0005X Orthopaedic Surgery Sports Medicine | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine | |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2020-02-24 |