NPI: 1902854433 · BOISE, ID 83704 · Orthopaedic Surgery Physician · NPI assigned 05/05/2006
| Authorized Official | JACK, LISA (PRACTICE MANAGER) |
| NPI Enumeration Date | 05/05/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 13 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 4325F | 13 | 13 | $0.00 |