| NPI | 1558753749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE MILLARD Owner 808-261-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD240) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI MD9545) |
| 363LF0000X Nurse Practitioner, Family (Licence: HI APRN380) | |
| 363LF0000X Nurse Practitioner, Family (Licence: HI APRN62) | |
| 363LF0000X Nurse Practitioner, Family (Licence: HI APRN1844) | |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2023-05-08 |