| NPI | 1952845109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN LEWIS Manager 208-955-8215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP122A) |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2016-12-07 |