Samuel Jesse Nieves, IDHS Valid NPI

Individual provider · Independent Duty Corpsman · Petaluma, CA

NPI

1922815547

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

2024-12-17

Last updated

2024-12-17