NPI age
20 years
Enumerated 2006-02-02
Across 78 active urology providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (CA) | A81753 | STATE |
| 01 (PA) | MD448962 | STATE |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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