| NPI | 1063578664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAYNE D ROBERTS Physician 208-587-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-91) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-265) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2008-02-25 |