| NPI | 1891025334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY D SEWELL Manager 208-525-4888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: ID M10198) |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2010-01-06 |