| NPI | 1770236564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY WATSON Nurse Practitioner 208-890-0341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health |
| Enumeration Date | 2022-02-01 |
| Last Update Date | 2022-02-01 |