Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | M-15213 | ID |
NPI | 1265605901 |
---|---|
Provider Name | Dr. Kyle James Tobler |
First Address | Boise, ID 83712-7792 |
Second Address | Boise, ID 83712-7792 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2008 |
Last Update Date | 22/06/2020 |