Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 17791 | HI |
NPI | 1023209566 |
---|---|
Provider Name | Jae H. Lim |
First Address | Honolulu, HI 96819-1469 |
Second Address | Honolulu, HI 96819-1469 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2007 |
Last Update Date | 24/06/2021 |