| NPI | 1255981643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JAMES FARRELL Sole Member 435-400-1051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2022-10-14 |