NPI | 1265621908 |
---|---|
Entity Type | Organization |
Authorized Contact | SUSAN MELCHIORE Managing Physician 208-967-4771 |
Organization Subpart ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
Enumeration Date | 2007-10-18 |
Last Update Date | 2019-08-04 |