Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | M-9462 | ID |
NPI | 1306995188 |
---|---|
Provider Name | Sarah L Hirsch |
First Address | Boise, ID 83712-6241 |
Second Address | Boise, ID 83712-6269 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 05/12/2013 |