Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | PO235 | HI |
NPI | 1225534159 |
---|---|
Provider Name | Kristy Kimi Iwahashi-Marquez |
First Address | Aiea, HI 96701-4715 |
Second Address | Aiea, HI 96701-4715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2018 |
Last Update Date | 15/11/2021 |