NPI age
13 years
Enumerated 2013-03-20
Across 19 active obstetrics & gynecology providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1629310347 | |
| 05 (WA) | 2140750 |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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