NPI | 1043716624 |
---|---|
Other Name | BUCKY RIBBECK |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX T1533) |
Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: TX 407) |
Enumeration Date | 2018-04-03 |
Last Update Date | 2023-08-18 |