Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DT2708 | HI |
NPI | 1063934602 |
---|---|
Provider Name | Dr. Andrew Inaba |
First Address | Honolulu, HI 96814-4400 |
Second Address | Honolulu, HI 96814-4400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2017 |
Last Update Date | 13/05/2020 |