NPI | 1265612097 |
---|---|
Entity Type | Organization |
Authorized Contact | BENNETT NAVARRO Owner 801-979-5330 |
Organization Subpart ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: UT 1966054405) |
Enumeration Date | 2007-11-09 |
Last Update Date | 2008-03-10 |