| NPI | 1164140679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA L SESTAK Manager 405-615-2421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2022-08-19 |
| Last Update Date | 2022-08-19 |