Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 200601972 | NC |
NPI | 1164635702 |
---|---|
Provider Name | Christine Marie Wu |
First Address | Wake Forest, NC 27587-4746 |
Second Address | Wake Forest, NC 27587-4746 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 17/02/2016 |