| NPI | 1174244313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON MARAY WILSON Obgyn 918-549-0497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2022-09-07 |