NPI age
20 years
Enumerated 2005-09-26
Across 10 active surgery providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (IL) | 036-110940 |
Part of a multi-provider practice. 64 other active providers share this practice address in NPPES.
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →