| NPI | 1356811764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL CLANCY Attorney 918-595-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2018-11-28 |
| Last Update Date | 2023-06-22 |