| NPI | 1568760676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID SOUVENIR Owner/Physician 208-765-9092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2011-03-14 |