Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner | 4493 | HI |
NPI | 1033239645 |
---|---|
Provider Name | Tania Kehaulani Cortes IX |
First Address | Kailua, HI 96734-3733 |
Second Address | Kailua, HI 96734-3733 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 21/11/2019 |