Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0900X | Dermatopathologist | 2753 | HI |
NPI | 1376568527 |
---|---|
Provider Name | David M Huntley |
First Address | Kailua, HI 96734-2519 |
Second Address | Kailua, HI 96734-2519 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 08/07/2007 |