| NPI | 1104131721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG W DINWIDDIE President 405-771-4151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OK 1037) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2010-11-12 |