Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 7772 | HI |
NPI | 1063486520 |
---|---|
Provider Name | Walter K. Imai |
First Address | Tripler Amc, HI 96859-5001 |
Second Address | Tripler Amc, HI 96859-5001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 08/07/2007 |