Individual
DERRICK DE SOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1301 PUNCHBOWL ST, HONOLULU, HI 96813-2402
(808) 538-9011
Mailing address
1301 PUNCHBOWL ST, HONOLULU, HI 96813-2402
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
RN74889
HI
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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