| NPI | 1841803137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE JAIMEZ President/CEO 801-810-8267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2020-08-26 |