Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 20462 | HI |
NPI | 1013573823 |
---|---|
Provider Name | Miriam Berchuk |
First Address | Calgary, ALBERTA T2S1V2 |
Second Address | Wailuku, HI 96793-2526 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2019 |
Last Update Date | 16/05/2019 |