| NPI | 1861991937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD PEW Vice President 307-262-9410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2025-01-07 |