| NPI | 1013522564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANDON TROST Owner, Md 801-655-0015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2021-05-12 |