| NPI | 1700088002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL JENKINS Doctor 208-381-7336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: ID M6943) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2012-06-20 |