NPI age
19 years
Enumerated 2006-05-31
Across 228 active obstetrics & gynecology providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | M7753 | IDAHO STATE MEDICAL LICEN |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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