| NPI | 1710738968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN HABBABA Patient Services Coordinator 208-731-9404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2024-07-03 |