| NPI | 1689906976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE WHITE Secretary 801-571-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2011-01-19 |