| NPI | 1174095038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY BAHE Managing Member 918-426-6005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology | |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2019-10-08 |