| NPI | 1790162980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT COLIN FERGUSON Sole Member 808-887-6543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: HI md16732) |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2015-04-27 |