| NPI | 1104379536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANTHONY PASQUALE CEO 808-945-5433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: HI DOS696) |
| Additional Taxonomies | 207RS0010X Internal Medicine Sports Medicine |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2017-02-21 |