Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 8615 | SD |
NPI | 1093909756 |
---|---|
Provider Name | Brian Sabado Pepito |
First Address | Sioux Falls, SD 57108-2592 |
Second Address | Sioux Falls, SD 57108-2592 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2007 |
Last Update Date | 06/08/2014 |