| NPI | 1720315823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA MAE STOIA Certified First Assist 208-880-0204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: ID 117520) |
| Enumeration Date | 2009-11-10 |
| Last Update Date | 2016-05-19 |