| NPI | 1225017817 |
|---|---|
| Professional Name | WADE WALLACE WILDE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.074229) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 18724) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2020-11-23 |