Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | HI 150 | HI |
NPI | 1134338759 |
---|---|
Provider Name | Carrie J Brennan |
First Address | Kapaa, HI 96746-1701 |
Second Address | Kapaa, HI 96746-1701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |