Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 35044361 | OH |
NPI | 1346221033 |
---|---|
Provider Name | Prashant S Kothari |
First Address | Tiffin, OH 44883 |
Second Address | Tiffin, OH 44883 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 16/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0422680 | (05) | OH |