| NPI | 1124226378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | M LESLIE REEDY Office Manager 208-367-7502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ID M-5296) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2007-07-10 |