Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RP1001X | Pulmonary Disease | 23571 | WI |
Y | 207RS0012X | Sleep Medicine | 23571 | WI |
NPI | 1033185046 |
---|---|
Provider Name | Mary E Klink |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 15/11/2017 |