| NPI | 1104871359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL EDWARD BOONE Clinical Psychologist 502-287-5915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 286500000X Military Hospital (Licence: IN 20042074A) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2020-08-22 |