Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 311 | HI |
NPI | 1114565397 |
---|---|
Provider Name | Randall James Carpio JR. |
First Address | Kapaau, HI 96755-0932 |
Second Address | Hawi, HI 96719 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2019 |
Last Update Date | 18/12/2019 |