Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | CCE-000004 | OH |
NPI | 1578985305 |
---|---|
Provider Name | Prof. Jose Luis Peiro-Ibanez |
First Address | Cincinnati, OH 45229-3026 |
Second Address | Cincinnati, OH 45229-3026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2014 |
Last Update Date | 14/01/2014 |