| NPI | 1770219842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVIEVE AYIN CFO 808-791-6183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2023-03-16 |