Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 2016016957 | MO |
NPI | 1023468436 |
---|---|
Provider Name | Dr. Francis Aversano |
First Address | Saint Louis, MO 63110-1010 |
Second Address | Saint Louis, MO 63110-1010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2016 |
Last Update Date | 20/06/2016 |