| NPI | 1336251073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ROBERT MILLER Medical Director 208-706-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ID M7853) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-08-01 |