| NPI | 1366965170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RITA NALUBEGA Md 701-662-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2019-01-07 |