Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | MD-5939 | HI |
NPI | 1003904632 |
---|---|
Provider Name | Dr. Joseph R. Vierra |
First Address | Honolulu, HI 96813-3009 |
Second Address | Honolulu, HI 96813-3009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 23/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C97651 | (02) | HI |