| NPI | 1700286341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA L HILL Owner 918-214-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OK 17349) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OK 1214) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2014-09-02 |