NPI | 1396949616 |
---|---|
Doing Business As | KEITH BRAVO, MD |
Entity Type | Organization |
Authorized Contact | KEITH BRAVO Staff 304-723-4328 |
Organization Subpart ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: WV 19983) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 19983) |
Enumeration Date | 2007-06-12 |
Last Update Date | 2007-12-31 |