| NPI | 1659720936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FATIMA VILICH Medical Director 435-782-9384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 10369621-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036097212) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2022-07-21 |