| NPI | 1588017446 |
|---|---|
| Former Name | GENEVIEVE MARY SAN MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042.0014582) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 9858) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2025-01-10 |