| NPI | 1790291276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH A HILL Nurse Practitioner 208-497-0680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ID 57138) |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2021-01-19 |