| NPI | 1073384814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER E BRODIS Owner 801-721-4587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2024-01-10 |
| Last Update Date | 2024-01-10 |