| NPI | 1376605550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAD JACKSON Owner 808-245-5383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: HI 10307) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-08-22 |