| NPI | 1184657389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRAHAM WETHERLEY President 208-322-1686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: ID M5449) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID NP642A) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2014-11-17 |