# MR. RUDY J LOPEZ

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1114284809
- **Gender:** Man
- **Credential:** SO-IDC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1710I1002X | Independent Duty Corpsman | NEC HM8403 | NC | Yes |

## Other

- **Enumeration date:** 04/18/2012
- **Last updated:** 04/18/2012
