Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 5384844-1205 | UT |
Y | 111NI0900X | Internist | 5384844-1205 | UT |
N | 207RC0200X | Critical Care Medicine | 5384844-8905 | UT |
N | 2080P0203X | Pediatric Critical Care Doctor | 5384844-8905 | UT |
NPI | 1255502217 |
---|---|
Provider Name | Eliotte L Hirshberg |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | Murray, UT 84107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2008 |
Last Update Date | 25/09/2018 |