Individual
GREGORY TSUDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
338 E BANNOCK ST, BOISE, ID 83712-6207
(208) 336-0895
Mailing address
338 E BANNOCK ST, BOISE, ID 83712-6207
(208) 336-0895
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
105706
UT
Other
Enumeration date
01/20/2015
Last updated
08/15/2015
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