| NPI | 1831108166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELL I MADONNA Director Of Contracting And Pe 801-587-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care |
| 2086S0120X Surgery, Pediatric Surgery | |
| 2086S0127X Surgery, Trauma Surgery | |
| 363A00000X Physician Assistant | |
| 363AS0400X Physician Assistant, Surgical | |
| 363L00000X Nurse Practitioner | |
| 363LA2100X Nurse Practitioner, Acute Care | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2009-04-14 |