| NPI | 1528390895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY B GOLDEN Physician 208-227-2570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: ID 39651) |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2011-12-07 |