NPI | 1184824617 |
---|---|
Other Name | NONE |
Entity Type | Organization |
Authorized Contact | MICHAEL DAVID KENNER Doctor/Owner 208-453-1062 |
Organization Subpart ? | No |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
Enumeration Date | 2007-07-23 |
Last Update Date | 2007-07-23 |