| NPI | 1245414028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL J MOFFITT Physician 208-814-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2013-03-09 |