NPI | 1356839336 |
---|---|
Former Name | SARAH VICENTA ROE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 66236) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2018-04-25 |
Last Update Date | 2021-09-03 |