| NPI | 1407024367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL S GILLUM Owner 405-360-9588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0900X Dermatology Dermatopathology (Licence: OK 18048) |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2008-02-13 |