Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | MD-11842 | HI |
NPI | 1285729640 |
---|---|
Provider Name | Julie Won Ireland |
First Address | Ewa Beach, HI 96706-3607 |
Second Address | Ewa Beach, HI 96706-3608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 21/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000257543 | HMSA BILLING NUMBER (01) | HI |
57646501 | (05) | HI |
H65803 | (02) | HI |