Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2015015737 | MO |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 2015015737 | MO |
NPI | 1184091118 |
---|---|
Provider Name | Dr. Mauricio Kfuri JR. |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, MO 65212-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2015 |
Last Update Date | 22/04/2019 |