| NPI | 1891292991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER C BROWN Owner/Provider 208-661-7089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP-1327A) |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2018-04-06 |