| NPI | 1437350139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRIS GARNER Practice Administrator 208-356-6185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: ID NP-481A) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2020-08-22 |