| NPI | 1750548277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL RUDY PERKINS Clinic Administrator 808-682-2673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center Military/U.S. Coast Guard Outpatient |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2008-05-21 |