| NPI | 1649679366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA CASSAR Provider Enrollment Coordinator 405-605-6141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 18914) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2014-08-19 |