| NPI | 1104638451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN JAMES GRAY Facial Plastic Surgeon 208-631-6990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery |
| Enumeration Date | 2025-01-23 |
| Last Update Date | 2025-01-23 |