| NPI | 1629057179 |
|---|---|
| Professional Name | OCTAVIO P LICON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX F2773) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM 86-269) |
| 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: TX F2773) | |
| 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: NM 86-269) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2010-04-06 |