| NPI | 1831872126 |
|---|---|
| Doing Business As | RUSSELL G TACATA MD |
| Entity Type | Organization |
| Authorized Contact | RUSSELL G TACATA Owner 808-531-5454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-08-11 |
| Last Update Date | 2023-08-11 |