| NPI | 1073608378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL W JANSEN Owner/Physician 208-429-6693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |