| NPI | 1689914186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REANNA PARK Billing Specialist 208-525-2090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID N-35018) |
| Enumeration Date | 2013-02-20 |
| Last Update Date | 2013-02-20 |