| NPI | 1750644225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN CREE Program Director 208-282-3253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID MRM-1245) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2012-06-20 |