| NPI | 1013957885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA GREGG Adminstrator 208-338-1503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M-6044) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2015-06-10 |