| NPI | 1922125764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK J DWYER Md 208-853-0071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M9186) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID NP424A) |
| 363L00000X Nurse Practitioner (Licence: ID NP722A) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |