| NPI | 1952532814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED J PARKER Idmt/S Sgt 702-404-1142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2009-07-27 |