| NPI | 1902675556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALID AMRO HARARAH CEO/Owner 801-688-0210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine |
| Enumeration Date | 2023-12-25 |
| Last Update Date | 2023-12-25 |