| NPI | 1447485123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL JOSEPH HANSEN Physician Owner 801-399-3324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: UT 71920331204) |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service (Licence: UT 71920331204) |
| Enumeration Date | 2009-05-25 |
| Last Update Date | 2015-07-03 |