Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath | PBI CPES CERTIFIED | NV |
NPI | 1063795789 |
---|---|
Provider Name | Gretchen Vetter |
First Address | Boise, ID 83713-1313 |
Second Address | Boise, ID 83709-0009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2011 |
Last Update Date | 20/07/2021 |