Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 5211258-1205 | UT |
NPI | 1275740607 |
---|---|
Provider Name | Dr. Diane Alonso |
First Address | Murray, UT 84107-5704 |
Second Address | Murray, UT 84107-5704 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 28/12/2010 |