| NPI | 1740722115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE CHAN Sole Member 918-935-3240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2016-11-16 |
| Last Update Date | 2016-11-16 |