| NPI | 1285916072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMAKARA SOK Independent Duty Corpsman 262-705-8786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1710I1002X Military Health Care Provider, Independent Duty Corpsman |
| Enumeration Date | 2011-09-16 |
| Last Update Date | 2011-09-16 |