Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DT-1657 | HI |
NPI | 1114071107 |
---|---|
Provider Name | Dr. Earl Akio Hasegawa |
First Address | Kahului, HI 96732-1385 |
Second Address | Kahului, HI 96732-1385 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 08/07/2007 |