Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 35.143678 | OH |
NPI | 1154080372 |
---|---|
Provider Name | Paul William Wales |
First Address | Cincinnati, OH 45229 |
Second Address | Cincinnati, OH 45229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2021 |
Last Update Date | 15/12/2021 |