| 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 |