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Individual
MIRANDA CELESTE GASKAMP
Active
Individual
MIRANDA CELESTE GASKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
5213
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
04/25/2011
Last updated
07/18/2017
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