Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD-4524 | HI |
NPI | 1063517233 |
---|---|
Provider Name | Mr. Bernard Robinson |
First Address | Aiea, HI 00009-6701 |
Second Address | Ewa Beach, HI 96706-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 13/07/2007 |