| NPI | 1336648880 |
|---|---|
| Other Name | MARY WOLTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY p09459) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY P09459) |
| Enumeration Date | 2018-02-09 |
| Last Update Date | 2024-06-06 |