| NPI | 1750875183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN O AWINDA Sole Member 801-941-4034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2020-10-02 |