| NPI | 1669535787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELENIE NACHIMSON Credentialing Specialist 405-775-9350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: OK 14599) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2011-05-19 |