| NPI | 1265670061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | M ELIZABETH GERARD Owner 208-233-8344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: ID M-7059) |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2016-06-08 |