Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | M-15343 | ID |
NPI | 1851785067 |
---|---|
Provider Name | Sheri Poskanzer |
First Address | Boise, ID 83712-6231 |
Second Address | Boise, ID 83712-6241 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2015 |
Last Update Date | 01/12/2021 |