Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | DOS-1839 | HI |
NPI | 1003252966 |
---|---|
Provider Name | Richard Kline |
First Address | Honolulu, HI 96816-3816 |
Second Address | Aiea, HI 96701-4713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2013 |
Last Update Date | 22/01/2021 |