NPI | 1336236587 |
---|---|
Entity Type | Organization |
Authorized Contact | JANELL I MADONNA Director Of Contracting And Pe 801-587-6464 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207RR0500X Internal Medicine Rheumatology |
363A00000X Physician Assistant | |
363AM0700X Physician Assistant Medical | |
363L00000X Nurse Practitioner | |
363LA2200X Nurse Practitioner Adult Health | |
Enumeration Date | 2006-10-09 |
Last Update Date | 2009-04-14 |