Individual
NITSALA PHITSAMAY MARX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
94-315 LEONUI ST STE 205, WAIPAHU, HI 96797-2370
(808) 429-5330
Mailing address
94-1063 MEAHALE PL, WAIPAHU, HI 96797-4024
(808) 429-5330
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
227-LD
HI
133V00000X
Registered Dietitian
895937
HI
Other
Enumeration date
07/11/2019
Last updated
01/03/2020
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