| NPI | 1639639321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE L BRACKEN Credentialing 918-448-6160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2019-04-03 |