Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY12357 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY12357 | CA |
NPI | 1003866906 |
---|---|
Provider Name | Dr. Cole Lew |
First Address | Honolulu, HI 96819 |
Second Address | Honolulu, HI 96819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 08/07/2007 |