| NPI | 1477599603 |
|---|---|
| Other Name | JAMIE COSTA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: WI 49844) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 1724-850) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2021-01-04 |