| NPI | 1750563540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HASSINGER Partner 208-855-2410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ID TEMP) |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2015-08-27 |