Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | MD12272 | HI |
NPI | 1154342376 |
---|---|
Provider Name | Dr. Noel Icasas Termulo |
First Address | Wailuku, HI 96793-2038 |
Second Address | Wailuku, HI 96793-2038 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2006 |
Last Update Date | 03/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H81510 | (02) | HI |