| NPI | 1659719177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY L BOWEN Sole Member 208-947-5390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP816A) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2013-06-06 |