Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 685 | HI |
NPI | 1073947370 |
---|---|
Provider Name | Dr. Gloria Kay Hamada |
First Address | Kailua, HI 96734-3714 |
Second Address | Kailua, HI 96734-2544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2013 |
Last Update Date | 03/09/2013 |