NPI | 1063822633 |
---|---|
Entity Type | Organization |
Authorized Contact | SHAUN TEDESCO Owner/Physician 405-936-0504 |
Organization Subpart ? | No |
Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: OK 25729) |
Enumeration Date | 2014-05-05 |
Last Update Date | 2014-05-05 |