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Individual
KIPP CRYAR
Active
Individual
KIPP CRYAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
322468
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2529129
—
LA
01
—
MD.057033
STATE MEDICAL LICENSE
LA
Enumeration date
04/09/2014
Last updated
06/09/2022
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