NPI | 1336346469 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMI CHARLTON Office Manager 208-734-3455 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP710A) |
Enumeration Date | 2007-07-02 |
Last Update Date | 2020-08-22 |