Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MAT-10919 | HI |
NPI | 1003191172 |
---|---|
Provider Name | Mrs. Zorica Zekovic |
First Address | Honolulu, HI 96815-4717 |
Second Address | Honolulu, HI 96815-4717 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2011 |
Last Update Date | 19/10/2011 |