| NPI | 1477188902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID C WHYBREW Sole Member 918-859-5334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2021-03-23 |