| NPI | 1790989713 |
|---|---|
| Former Name | AUDREY JEAN WOLF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00997) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 0010-00997) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2023-02-03 |