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Individual

IMRUSTY SIMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RBT

Contact information

Practice address
1405 ERNEST ST APT 4, HONOLULU, HI 96822-3879
(808) 439-3147
Mailing address
1405 ERNEST ST APT 4, HONOLULU, HI 96822-3879

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
RBT-20-141891
HI

Other

Enumeration date
08/20/2021
Last updated
08/20/2021
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