| NPI | 1710289483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY DINWIDDIE Managing Member 405-601-0954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OK 1037) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2010-12-01 |