| NPI | 1740216175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA SMITH Administrator 208-433-9466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology |
| 2085R0204X Radiology, Vascular & Interventional Radiology | |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2024-03-04 |