| NPI | 1194330118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERSON B GAUFIN CEO 801-616-3675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2024-04-25 |