| NPI | 1265427256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA BUTTERFIELD Credentialing Manager 208-489-1431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2024-02-12 |