| NPI | 1700621661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMI YANTIS Office Manager 208-649-8347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2024-07-10 |