| NPI | 1902153190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAUTAM SIRAM Director 301-785-4559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: MD D0074565) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2012-08-07 |