| NPI | 1871190215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE SPENCER LONGMORE Owner 208-760-7707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |