| NPI | 1306724216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM CHRISTOPHER KNUDSON Child & Adolescent Psychiatrist 208-221-8088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2025-08-27 |
| Last Update Date | 2025-08-27 |