Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 8809916-1205 | UT |
NPI | 1295001105 |
---|---|
Provider Name | Martha Anice Andrea Monson |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | Murray, UT 84107-5701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2012 |
Last Update Date | 04/11/2021 |