| NPI | 1679967053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA TOLMAN Manager 208-557-2700 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2015-03-25 |