| NPI | 1871058362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL L PENA Insurance Credentialing Specialistg 405-272-7452 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2019-02-08 |