Individual
DANIEL BONILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1717 ARLINGTON AVE, CALDWELL, ID 83605-4802
(208) 459-4641
Mailing address
1717 ARLINGTON AVE, CALDWELL, ID 83605-4802
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
78711
ID
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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