| NPI | 1952357360 |
|---|---|
| Former Name | SOPHIA GRIMBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2002028631) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 45401) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2020-05-18 |