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1225772502
BOMAONYE TIENABESO
EDMOND, OK
NPI
1225772502
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-04-23
Last Update Date
2022-04-23
Business Address
BOMAONYE TIENABESO MD
1316 NW 170TH ST
EDMOND, OK 73012-7410
Phone number: 405-476-0822
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Mailing Address
BOMAONYE TIENABESO MD
1316 NW 170TH ST
EDMOND, OK 73012-7410
Phone number: 405-476-0822
Copy
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