| NPI | 1316305519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG D NEBEKER Nurse Anesthetist 208-569-5818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center Pain (Licence: ID RNA382A) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-02-02 |