163WG0100X
Boise, ID
Specialty
163WG0100X
Credential
WHNP
NPI
1679971741
6259 W. Emerald St., Boise, ID 83704
(208) 489-1900Confirm current license and practice information on the official CMS NPI registry.
View NPI RecordThis surgeon specializes in 163wg0100x procedures performed in an outpatient ambulatory surgical setting.
NUCC Taxonomy: 163WG0100X