Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 1400 | HI |
NPI | 1184839920 |
---|---|
Provider Name | Dr. Robert Minoru Obatake |
First Address | Honolulu, HI 96814-3237 |
Second Address | Honolulu, HI 96814-3237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 08/07/2007 |