| NPI | 1306036314 |
|---|---|
| Former Name | KRISTIN E WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR DO156086) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5101017373) |
| 207V00000X Obstetrics & Gynecology (Licence: MI 5315031830) | |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2020-04-20 |