| NPI | 1477816809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROANNE MANCARI Owner 208-731-6971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: ID NP-986A) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2013-08-26 |