| NPI | 1457732000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM P WILSON Owner 208-524-4381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: ID M 5527) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2015-06-15 |