NPI | 1851799621 |
---|---|
Entity Type | Organization |
Authorized Contact | CAITLIN A ST MARK Practice Manager 208-758-0486 |
Organization Subpart ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery |
Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery |
208200000X Plastic Surgery | |
2082S0105X Plastic Surgery, Surgery of the Hand | |
Enumeration Date | 2014-12-10 |
Last Update Date | 2023-11-01 |