Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | AT-253 | HI |
NPI | 1588294623 |
---|---|
Provider Name | Rachel C Boyle |
First Address | Mililani, HI 96789-3524 |
Second Address | Honolulu, HI 96813-5703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2020 |
Last Update Date | 16/01/2020 |