| NPI | 1962440966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK J PAYNE Member 208-771-3722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2023-08-31 |