| NPI | 1578627246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP C BLUM President 208-525-2090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-08-22 |