Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 3603 | ID |
NPI | 1033289798 |
---|---|
Provider Name | Dr. Francis Joseph Dega |
First Address | Boise, ID 83702-3042 |
Second Address | Boise, ID 83702-4501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 08/07/2007 |