| NPI | 1225083520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE R NEWTON Member 208-368-0095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology |
| 2085R0204X Radiology Vascular & Interventional Radiology | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2007-08-03 |