| NPI | 1962510438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY DULLYE Surgeon 918-585-3372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OK 1569) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OK 1962) |
| Enumeration Date | 2006-08-26 |
| Last Update Date | 2020-08-22 |