NPI | 1336100312 |
---|---|
Former Name | SARAH J. SANDBLOM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 3751) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R7662) |
Enumeration Date | 2006-03-30 |
Last Update Date | 2020-11-19 |