| NPI | 1003465915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUSTAFA MOHAMMED MOAZAM Medical Director 918-691-9129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 2080P0207X Pediatrics Pediatric Hematology-Oncology | |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2019-09-04 |