| NPI | 1093040479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ODETTE BOLANO President 208-367-2118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| 208M00000X Hospitalist | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 363LF0000X Nurse Practitioner, Family | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207T00000X Neurological Surgery | |
| 207V00000X Obstetrics & Gynecology | |
| 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine | |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 208600000X Surgery | |
| 2086S0129X Surgery, Vascular Surgery | |
| 364S00000X Clinical Nurse Specialist | |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2018-04-27 |