| NPI | 1821127077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHA DESANO Office Manager 208-251-6690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M-3307) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |