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Individual
ANCESLO IDICULA
Active
Individual
ANCESLO IDICULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
BP10052704
TX
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
U5988
TX
Other
Enumeration date
05/11/2015
Last updated
09/08/2023
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