| NPI | 1306993597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI A WILKINS Office Manager 208-658-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ID M-5492) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-379A) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2010-01-26 |