| NPI | 1275877912 |
|---|---|
| Former Name | SARA MARIE MOMOLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MT NUR-RN-LIC-46519) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704263797) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2018-12-11 |