364SF0001X
Coeur D Alene, ID
Specialty
364SF0001X
NPI
1790192284
1686 W. Riverstone Dr, Coeur D Alene, ID 83814
(208) 765-4807Confirm current license and practice information on the official CMS NPI registry.
View NPI RecordThis surgeon specializes in 364sf0001x procedures performed in an outpatient ambulatory surgical setting.
NUCC Taxonomy: 364SF0001X