| NPI | 1295009728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBEN ARTRURO SANCHEZ Idc 619-925-0259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1710I1002X Military Health Care Provider, Independent Duty Corpsman |
| Enumeration Date | 2012-03-01 |
| Last Update Date | 2012-03-01 |