Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OD-607 | HI |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 607 | HI |
NPI | 1063586741 |
---|---|
Provider Name | Dr. Joel Ernest Punzal |
First Address | Lihue, HI 96766-8022 |
Second Address | Lihue, HI 96766-8022 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 14/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
547903-01 | (05) | HI |
U98719 | (02) | HI |