| NPI | 1801152426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRASE MAHAN Owner 918-895-7680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2022-07-21 |