Individual
MATTHEW LEE TOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3288 MOANALUA RD, HONOLULU, HI 96819-1469
(808) 432-0000
Mailing address
3288 MOANALUA RD, HONOLULU, HI 96819-1469
(808) 432-0000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-77781
HI
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN-1992
HI
Other
Enumeration date
04/27/2015
Last updated
05/24/2021
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