| NPI | 1649518200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM SEAL Billing Managerf 405-762-6002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2013-01-16 |