Individual
KELLI ANN IFUKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5400 S RAINBOW BLVD, LAS VEGAS, NV 89118-1825
(702) 853-3561
Mailing address
1557 ALA MAHAMOE ST, HONOLULU, HI 96819-1766
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/09/2019
Last updated
04/09/2019
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