Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 3227191202 | UT |
NPI | 1235427758 |
---|---|
Provider Name | Michael Joseph Cerami |
First Address | Salt Lake City, UT 84106-3311 |
Second Address | Salt Lake City, UT 84106-3311 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2011 |
Last Update Date | 18/07/2011 |