| NPI | 1881881118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN ANNETTE JEFFREYS Office Manager 208-746-4479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2007-10-01 |