Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | M-6542 | ID |
NPI | 1215137526 |
---|---|
Provider Name | Dr. Dean Edward Lapinel |
First Address | Boise, ID 83702-1857 |
Second Address | Boise, ID 83702-1857 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2007 |
Last Update Date | 24/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D30016 | (02) | ID |