NPI | 1376078303 |
---|---|
Entity Type | Organization |
Authorized Contact | NATHAN MOSS Owner 208-818-6181 |
Organization Subpart ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AZ AP8631) |
Enumeration Date | 2017-04-27 |
Last Update Date | 2021-06-10 |