| NPI | 1962129726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL OLIVIA CRIST Certified Surgical First Assist 918-944-8333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2022-10-24 |
| Last Update Date | 2022-10-24 |