| NPI | 1366098774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN JEFFREY HULL Owner Of Group 208-930-4944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2024-08-12 |