Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 4301092569 | MI |
N | 208600000X | Surgeon | 4301092569 | MI |
Y | 2086X0206X | Surgical Oncologist | 4301092569 | MI |
NPI | 1063674497 |
---|---|
Provider Name | Jill K Onesti |
First Address | Grand Rapids, MI 49503-4608 |
Second Address | Grand Rapids, MI 49503-4608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 04/01/2017 |