| NPI | 1952504763 |
|---|---|
| Former Name | KRISTIN A WENNERSTROM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 34.011067) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 005415) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2016-02-08 |