Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 125.067183 | IL |
Y | 2080P0203X | Pediatric Critical Care Doctor | 11262359-1204 | UT |
NPI | 1225410699 |
---|---|
Provider Name | Dr. Lauren Reiter |
First Address | Salt Lake City, UT 84108-1287 |
Second Address | Salt Lake City, UT 84108-1287 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2015 |
Last Update Date | 12/06/2019 |