| NPI | 1275770752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ERICH ROTH President 808-923-7684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: HI md11262) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: HI md11262) |
| 208000000X Pediatrics (Licence: HI md11262) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI md11262) | |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: HI md11262) | |
| 171100000X Acupuncturist (Licence: HI hi633) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| 226300000X Kinesiotherapist | |
| Enumeration Date | 2009-01-20 |
| Last Update Date | 2015-05-08 |