Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 1812 | HI |
NPI | 1053440305 |
---|---|
Provider Name | Darin K Iha |
First Address | Honolulu, HI 96814-3801 |
Second Address | Honolulu, HI 96814-3801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2007 |
Last Update Date | 08/07/2007 |