| NPI | 1467499418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A JOHNSON Physician 208-814-7150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: ID M9086) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2013-03-09 |