| NPI | 1043672850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE DAWN PAYNE Owner/Manager 208-525-2090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-03-22 |