KIMIKNU MENTORE

BOISE, ID
NPI1184128480
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: ID  2771058)
Additional Taxonomies207RI0200X Internal Medicine, Infectious Disease
(Licence: NM  MD2024-0242)
390200000X Student in an Organized Health Care Education/Training Program
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2018-03-21
Last Update Date2025-07-10
Business Address
KIMIKNU MENTORE MD
5966 W CURTISIAN AVE
BOISE, ID 83704-8801
Phone number: 208-302-5450
Mailing Address
KIMIKNU MENTORE MD
PO BOX 190930
BOISE, ID 83719-0930
Phone number: 208-367-5170