| NPI | 1710053756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM KARL DOMARAD Physician 208-552-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ID O343) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-08-22 |