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Individual

MUM GAUTAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
326 E GORDON LN APT 5, SALT LAKE CITY, UT 84107-2783
(801) 712-8565
Mailing address
326 E GORDON LN APT 5, SALT LAKE CITY, UT 84107-2783
(801) 712-8565

Taxonomy

Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary

Other

Enumeration date
01/15/2015
Last updated
01/15/2015
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