| NPI | 1659803120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH CATHERINE LUCENTA Owner 918-630-5693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 68962) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2017-04-03 |