Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | LA00007 | RI |
NPI | 1114169406 |
---|---|
Provider Name | Dr. Petra Margarete Klinge |
First Address | Providence, RI 02903 |
Second Address | Providence, RI 02903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2009 |
Last Update Date | 01/04/2009 |