| NPI | 1417528399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLY KALEO CORREA Owner 808-756-0334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine |
| 261QH0100X Clinic/Center Health Service | |
| Enumeration Date | 2021-07-01 |
| Last Update Date | 2023-06-16 |