| NPI | 1255449898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES R WILLIS President 208-525-4888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: ID M7012) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2020-08-22 |