| NPI | 1891857835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELL I MADONNA Director Of Contracting And Pe 801-587-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0001X Internal Medicine, Clinical & Laboratory Immunology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RI0200X Internal Medicine, Infectious Disease | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2009-04-14 |