Individual
TRACII WRAITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1822 KEEAUMOKU ST, HONOLULU, HI 96822-3001
(808) 585-1451
Mailing address
1822 KEEAUMOKU ST, HONOLULU, HI 96822-3001
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/25/2021
Last updated
07/23/2021
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