NPI | 1740417039 |
---|---|
Former Name | SARAH GRIMM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 288323) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 241076) |
207Q00000X Family Medicine (Licence: VT 04200543) | |
Enumeration Date | 2009-06-15 |
Last Update Date | 2023-06-29 |