Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 9793656-1205 | UT |
NPI | 1326364175 |
---|---|
Provider Name | Allison Rose Smego |
First Address | Salt Lake City, UT 84130-0180 |
Second Address | Salt Lake City, UT 84113-1125 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2010 |
Last Update Date | 12/11/2021 |