| NPI | 1710766159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER MUNGA GAKWA Pmhnp 208-284-7100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0810X Clinical Nurse Specialist, Psych/Mental Health, Child & Family |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2024-09-04 |