Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 11739745-1205 | UT |
NPI | 1700290178 |
---|---|
Provider Name | Sarah Drejet |
First Address | Salt Lake City, UT 84132-0001 |
Second Address | Salt Lake City, UT 84112-5500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2014 |
Last Update Date | 20/10/2021 |