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 |