Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 70800071205 | UT |
NPI | 1154411890 |
---|---|
Provider Name | Dr. Ellen M Arch |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | St George, UT 84770-3705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 04/12/2013 |