| NPI | 1154631489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC ALFARO Sole Proprietor 801-831-8141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 58988864405) |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2021-12-06 |