Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN-1571 | HI |
N | 363L00000X | Nurse Practitioner | SPOO8067 | PA |
N | 363LA2100X | Nurse Practitioner - Acute Care | APRN-1571 | HI |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN-1571 | HI |
NPI | 1275613424 |
---|---|
Provider Name | Mr. Martin Camacho |
First Address | Honolulu, HI 96813-2402 |
Second Address | Honolulu, HI 96813-2402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 23/09/2013 |