Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 11090 | HI |
NPI | 1356323091 |
---|---|
Provider Name | Dr. John Leslie Frattarelli |
First Address | Kailua, HI 96734-2519 |
Second Address | Kailua, HI 96734-2519 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 16/12/2008 |