| NPI | 1356330922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA LYNN SMITH Clinical Director 208-298-3002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2012-10-12 |