| NPI | 1265829303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD CURTIS Manager 208-866-8277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ID 116257) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: ID 116257) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2015-06-18 |