NPI | 1295273001 |
---|---|
Former Name | AMANDA M KLEM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4987) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP4987) |
Enumeration Date | 2017-02-01 |
Last Update Date | 2024-02-15 |