| NPI | 1164064119 |
|---|---|
| Former Name | CORINNE MONIQUE SHIELDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71009435A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28173822A) |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2019-10-10 |