| NPI | 1205948783 |
|---|---|
| Former Name | AGUSTIN RIVAS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME100281) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL me100281) |
| 208000000X Pediatrics (Licence: FL me 100281) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-11-06 |