Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 0102203438 | VA |
NPI | 1013295716 |
---|---|
Provider Name | Dr. Jeffrey Brian Hainsworth |
First Address | Honolulu, HI 96818 |
Second Address | Honolulu, HI 96859 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2011 |
Last Update Date | 08/10/2021 |