| NPI | 1922367184 |
|---|---|
| Former Name | KIRSTEN VIRGINIA FORSBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: IL 036.147053) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.125770) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2019-04-22 |