Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 2492 | MA |
NPI | 1093178709 |
---|---|
Provider Name | Christopher Wolf |
First Address | Springfield, MA 01104-2483 |
Second Address | Springfield, MA 01104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2016 |
Last Update Date | 30/12/2021 |