| NPI | 1831332873 |
|---|---|
| Former Name | KRISTA WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD60438099) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD60438099) |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2014-09-03 |