NPI | 1295093912 |
---|---|
Former Name | DESIREE LASTRAPES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians |
Enumeration Date | 2012-05-01 |
Last Update Date | 2012-05-01 |