| NPI | 1942676598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT F. SMITH Manager/Sole Member 208-866-2473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M5963) |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2015-08-31 |