Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | MD3084 | HI |
NPI | 1003074386 |
---|---|
Provider Name | Dr. Than Tun |
First Address | Kapolei, HI 96707-4301 |
Second Address | Wahiawa, HI 96786-1841 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2008 |
Last Update Date | 23/05/2008 |