| NPI | 1861423410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE MOTES PFS Director 208-706-7062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID 03) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: ID 03) |
| 208M00000X Hospitalist (Licence: ID 03) | |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: ID 03) | |
| 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: ID 03) | |
| 208000000X Pediatrics (Licence: ID 03) | |
| 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: ID 03) | |
| 2085B0100X Radiology Body Imaging (Licence: ID 03) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2011-12-21 |