Luke Andrew Wagner, SOIDC Valid NPI

Individual provider · Independent Duty Corpsman · Coronado, CA

NPI

1013589407

Type

Individual (Type 1)

Primary specialty

Independent Duty Corpsman (Military Health Care Provider)

Specialty group

Other Service Providers

Taxonomy code

1710I1002X

Sex

Male

Sole proprietor

No

Enumerated

2021-07-14

Last updated

2021-07-14