| NPI | 1215122817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIO ESTEBAN BETANCOURT Independent Duty Corpsman 910-451-4042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1710I1002X Military Health Care Provider, Independent Duty Corpsman |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2008-04-20 |