Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD15662 | HI |
N | 207R00000X | Internist | MD15662 | HI |
N | 111NI0900X | Internist | MD15662 | HI |
NPI | 1043482706 |
---|---|
Provider Name | Marina Ostroukhova |
First Address | Honolulu, HI 96815-3919 |
Second Address | Honolulu, HI 96813-2431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2008 |
Last Update Date | 01/05/2014 |