Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | 58935 | MN |
Y | 2086S0105X | Surgery of the Hand | 65366 | WI |
NPI | 1174903884 |
---|---|
Provider Name | Guilherme Giusti |
First Address | Eau Claire, WI 54702-1510 |
Second Address | Eau Claire, WI 54703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2015 |
Last Update Date | 06/10/2021 |