| NPI | 1093148488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTI RENEE ESTEP Credentialing Mgr 405-521-1969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OK 13255) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2014-02-19 |