NPI | 1083611966 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHELLE LYNN HINES Business Office 801-262-3441 |
Organization Subpart ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
Additional Taxonomies | 103T00000X Psychologist |
2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology | |
2085R0202X Radiology, Diagnostic Radiology (Licence: UT 0055926) | |
Enumeration Date | 2005-07-07 |
Last Update Date | 2022-07-21 |