Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MDR-8100 | HI |
Y | 111NI0900X | Internist | MDR-8100 | HI |
NPI | 1003488453 |
---|---|
Provider Name | Raja Haris Rizwan |
First Address | Honolulu, HI 96813-2409 |
Second Address | Honolulu, HI 96813-2409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2021 |
Last Update Date | 14/07/2021 |