NPI | 1487016226 |
---|---|
Entity Type | Organization |
Authorized Contact | GINA COCCIMIGLIO Agpcnp 801-718-7280 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: UT 123071-4405) |
Enumeration Date | 2016-03-22 |
Last Update Date | 2017-08-29 |