| NPI | 1215946066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNINE RUSHTON-FOWLER Director Of Contracting 801-587-6336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2015-04-08 |