Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | 0101267673 | VA |
NPI | 1043702327 |
---|---|
Provider Name | Brett Kaplan |
First Address | Joint Base Lewis Mcchord, WA 98431-1000 |
Second Address | Joint Base Lewis Mcchord, WA 98431-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2018 |
Last Update Date | 23/06/2021 |