Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 11987 | NV |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 11987 | NV |
NPI | 1790896074 |
---|---|
Provider Name | Dr. Roman A Sibel |
First Address | Henderson, NV 89052-2982 |
Second Address | Henderson, NV 89052-3500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 17/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I61442 | (02) | NV |