Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 385 | HI |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 385 | HI |
NPI | 1285876581 |
---|---|
Provider Name | Mr. Christopher Donald Boling |
First Address | Waialua, HI 96791-9719 |
Second Address | Honolulu, HI 96813-6013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2009 |
Last Update Date | 01/04/2009 |