Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | D0081469 | MD |
NPI | 1124339932 |
---|---|
Provider Name | Dr. Kari Lynn Wagner |
First Address | Rockville, MD 20853-2759 |
Second Address | Bethesda, MD 20889-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2010 |
Last Update Date | 04/11/2016 |