| NPI | 1407273147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J HAAKE Physician 208-995-2802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID 207R00000X) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2016-03-17 |