Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MD13763 | HI |
NPI | 1225061674 |
---|---|
Provider Name | Dr. Elizabeth M Ignacio |
First Address | Honolulu, HI 96814-1701 |
Second Address | Honolulu, HI 96814-1701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 12/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H91006 | (02) | CA |