NPI | 1588379655 |
---|---|
Former Name | KASSIE MARIE KLEMANN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-APP-241172) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2023-01-23 |
Last Update Date | 2024-08-15 |