| NPI | 1871195131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY S BARLOW Owner 208-660-8814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| 207L00000X Anesthesiology | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology | |
| Enumeration Date | 2020-11-12 |
| Last Update Date | 2020-11-12 |