Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD7357 | HI |
Y | 208600000X | Surgeon | MD7357 | HI |
N | 2086S0105X | Surgery of the Hand | MD7357 | HI |
NPI | 1457434318 |
---|---|
Provider Name | Wiley Brunel |
First Address | Kailua, HI 96734-4418 |
Second Address | Kailua, HI 96734-4418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 15/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
06157701 | (05) | HI |
E76874 | (02) | HI |