| NPI | 1497055891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RADONA K BORGIALLI Office Manager 307-686-7031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WY 5967A) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WY 5967A) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WY 5967A) | |
| 207RS0012X Internal Medicine, Sleep Medicine (Licence: WY 5967A) | |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2010-11-01 |