| NPI | 1730714049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ROEHLING Nurse Practitioner / Owner 208-860-1398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2020-03-18 |