| NPI | 1164032884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUELLA PEDROSA VAN OSDOL Provider 808-392-5772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2020-08-06 |