| NPI | 1235716663 |
|---|---|
| Former Name | EMILY A WADE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2024017135) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2024-06-19 |