Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MDR7492 | HI |
NPI | 1003305749 |
---|---|
Provider Name | Dr. Jackyline Sanchez Prestosa |
First Address | Honolulu, HI 96826-1032 |
Second Address | Honolulu, HI 96826-1032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2018 |
Last Update Date | 08/05/2018 |