| NPI | 1639943632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY LEE WHITE Administrator 954-688-6884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2023-11-09 |
| Last Update Date | 2024-05-25 |