| NPI | 1609957455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM THOMSON Operations Manager 208-535-3410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M9225) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2013-03-11 |