| NPI | 1619921202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS MICHAEL SCHLICKMAN Owner 208-884-3770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID M7522) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2007-07-12 |