| NPI | 1174699722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEOFF SCHWIERMANN Administrator 208-356-0234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2018-07-18 |