Bruce Lancel Bernardo Lara, SUBMARINEIDC

Individual provider Military Health Care Provider · NPI 1912558610

Bruce Lancel Bernardo Lara, SUBMARINEIDC is a Military Health Care Provider in Groton, Armed Forces Europe. Practices as a sole proprietor. Registered with an NPI since 2019.

In the registry since: 2019

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Practice location Address may be wrong

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Fpo Ae 09587-2417
Groton, AE 06340
Phone: (714) 343-4488

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Specialties & licences

Military Health Care Provider (primary)	Taxonomy 171000000X

Record details

NPI number	1912558610
Entity type	Individual (Type 1)
Gender	Male
Credentials	SUBMARINEIDC
Sole proprietor	Yes
NPI enumerated	September 24, 2019
Last updated in NPPES	September 24, 2019