| NPI | 1275528630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN DANIEL Operations Manager 918-331-2330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2019-01-23 |