NPI | 1376170589 |
---|---|
Former Name | CARRIE DOROTHY KLEMM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: WI 1641-39) |
Enumeration Date | 2020-03-26 |
Last Update Date | 2020-03-26 |