| NPI | 1760030399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUHAMMAD SANAULLAH CEO 405-359-5370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2023-06-22 |