| NPI | 1104472349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONYA THOMAS BLIZZARD Physician 208-274-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2020-02-10 |