| NPI | 1902196314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIJIIT REIS Owner 808-263-8822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2022-08-31 |