| NPI | 1215944301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN M GATES Owner 307-632-6403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY 5374A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2007-09-10 |