NPI | 1407438203 |
---|---|
Former Name | KATHLEEN MARIE WILMES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 77519) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 33367) |
207P00000X Emergency Medicine (Licence: WI 85896) | |
Enumeration Date | 2021-04-22 |
Last Update Date | 2025-10-09 |