Individual
RALPH V NISHITANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9317 W PANDION CT, BOISE, ID 83714-6715
(208) 869-9878
Mailing address
9317 W PANDION CT, BOISE, ID 83714-6715
(208) 869-9878
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M-3282
ID
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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