Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 217758 | NC |
NPI | 1013370089 |
---|---|
Provider Name | Vincent Jack Rossi |
First Address | Charlotte, NC 28203-5812 |
Second Address | Charlotte, NC 28203-5812 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2016 |
Last Update Date | 29/03/2016 |