| NPI | 1295139889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARCE LATSIS Operations Manager 801-441-1002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 49966461204) |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2020-01-30 |