| NPI | 1134592694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELL BURGON Credentialing 801-701-6504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 333118-1205) |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2015-11-05 |