| NPI | 1275863243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN T WITTE Provider 208-343-6458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ID M5529) |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2018-03-20 |