| NPI | 1326428061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MARIE TAYLOR Director Of Credentialing 801-505-8021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: UT 92930960501) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2023-11-13 |