Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 10387262-1205 | UT |
NPI | 1205089455 |
---|---|
Provider Name | Eric Sorenson |
First Address | New York, NY 10065-4870 |
Second Address | Murray, UT 84107-6769 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2008 |
Last Update Date | 10/06/2019 |