| NPI | 1447752340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WARD Owner 808-699-6364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: HI MFT315) |
| Additional Taxonomies | 261QM0801X (Licence: HI 315) |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2018-03-06 |