| NPI | 1710466115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA JOHN Credentialing Coordinator 801-231-6986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2019-07-17 |