| NPI | 1679580237 |
|---|---|
| Former Name | KRISTI LYNNE BENGTSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0064240) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MD D0064240) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2014-12-19 |