| NPI | 1164042404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM BAGLEY Manager 808-312-8059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 251B00000X Case Management | |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2020-04-16 |