| NPI | 1902143134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT FRANK ENNIS Physician 208-994-8180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: ID M-11309) |
| Enumeration Date | 2013-01-08 |
| Last Update Date | 2020-04-09 |