| NPI | 1154556702 |
|---|---|
| Former Name | KRISTINA MARIE VANDER WALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MT 58064) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A108155) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2022-01-26 |