| NPI | 1356637599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA MORENO Provider Enrollment 801-587-6336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2011-10-25 |