| NPI | 1356887640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN A MOSS Np 208-818-6181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AZ AP8631) |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2017-01-11 |