| NPI | 1386642494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF HAMPSTEN Operations Director 208-237-1151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2022-07-21 |