NPI | 1871303503 |
---|---|
Entity Type | Organization |
Authorized Contact | TYESHA MOSQUITO Physician Relations Director 918-519-4090 |
Organization Subpart ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2025-01-14 |
Last Update Date | 2025-02-19 |