| NPI | 1467797449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE RUTHERFORD Administrator 208-457-7078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2023-03-15 |