| NPI | 1124462494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY ROBERT MCMASTER Physician/Surgeon 208-656-9646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2014-06-11 |