Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD-21534 | HI |
NPI | 1043551476 |
---|---|
Provider Name | Sean Paul Chislett |
First Address | Tripler Army Medical Center, HI 96859-5001 |
Second Address | Tripler Army Medical Center, HI 96859-5001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2013 |
Last Update Date | 02/12/2020 |