Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 813 | HI |
NPI | 1083891410 |
---|---|
Provider Name | Dr. Clyde S. Umaki |
First Address | Honolulu, HI 96826-1307 |
Second Address | Honolulu, HI 96826-1307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2008 |
Last Update Date | 28/01/2008 |