| NPI | 1811946619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELL I MADONNA Director Of Contracting And Pe 801-587-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| 207RH0003X Internal Medicine, Hematology & Oncology | |
| 207RH0000X Internal Medicine, Hematology | |
| 207RX0202X Internal Medicine, Medical Oncology | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2009-04-14 |