| NPI | 1619370434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY S ISPIRESCU Owner/Medical Director 208-263-9757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: ID W137644) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2014-10-07 |