| NPI | 1548515547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIKTOR LUCAS CORPUZ Resident 808-227-8089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |