Facts
- Status
- A
- Type
- Individual
- Enumeration date
- 2025-08-22
- Last updated
- 2025-08-22
Specialties
Licenses
- License HI
- AMD-1478
Location
- Practice location
- 3350 LOWER HONOAPIILANI RD # 21
- City
- LAHAINA HI
- Postal code
- 967618402
- Phone
- 808-667-7676
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.