| NPI | 1972976637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDI RICHARDSON Owner 208-476-9093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA-487A) |
| Enumeration Date | 2015-11-03 |
| Last Update Date | 2015-11-03 |