Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 8619014-4405 | UT |
NPI | 1093469116 |
---|---|
Provider Name | Lehai Lily Austin |
First Address | Midvale, UT 84047-5681 |
Second Address | Murray, UT 84107-5371 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2022 |
Last Update Date | 08/02/2022 |