| NPI | 1336220243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET M HOOVER Billing Lead 208-522-2996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: ID M7763) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: ID M4220) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: ID M9285) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2009-07-27 |