NPI | 1023547718 |
---|---|
Former Name | ANYA K WOLFE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: VT 016.0133910) |
Additional Taxonomies | 122300000X Dentist (Licence: MA 1857890) |
Enumeration Date | 2017-06-07 |
Last Update Date | 2024-04-16 |