| NPI | 1306944772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK LEE CAPENER Physician 208-524-7244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-10-11 |