NPI | 1255363420 |
---|---|
Former Name | KRISTY L WAELTZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-112397) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-112397) |
Enumeration Date | 2006-07-07 |
Last Update Date | 2015-10-29 |