| NPI | 1386272755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNSEY NIELSEN Clinical Administrator 385-388-8003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2023-08-22 |