Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MDR-8115 | HI |
Y | 111NI0900X | Internist | MDR-8115 | HI |
NPI | 1003484874 |
---|---|
Provider Name | Joshua Bruce Taylor |
First Address | Honolulu, HI 96813-2409 |
Second Address | Honolulu, HI 96813-2409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2021 |
Last Update Date | 16/06/2021 |