| NPI | 1225299282 |
|---|---|
| Former Name | KATHLEEN BERG WENNING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2015013428) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2011-00407) |
| 208000000X Pediatrics (Licence: MS 22539) | |
| 208000000X Pediatrics (Licence: KS 0437973) | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2015-08-05 |