| NPI | 1972500882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT A ERICKSON Medical Doctor 801-294-8288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208800000X Urology |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2025-01-15 |