| NPI | 1437473543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA YVONNE GRIMMETT Account Manager 208-267-1202 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: SC TL30852) |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2010-03-18 |