| NPI | 1720615875 |
|---|---|
| Former Name | AMANDA MARIE WOLF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA DO.OP.70068551) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR DO215184) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2026-02-26 |