| NPI | 1588769301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK S CHOWN Corp President 208-466-3322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ID M4350) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: ID M4350) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-08-22 |