| NPI | 1114908993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE BRINKLEY Office Manager 208-457-7067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2019-11-13 |