Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 276454-1205 | UT |
NPI | 1003820754 |
---|---|
Provider Name | Hildegard K Smith |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | Salt Lake City, UT 84143-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 04/11/2015 |