| NPI | 1740326990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRNA C. FISHER Owner 208-922-5130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP193A) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2010-12-02 |