Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 38469 | WI |
NPI | 1003868589 |
---|---|
Provider Name | Dr. Christopher E Wolfla |
First Address | Milwaukee, WI 53226-3462 |
Second Address | Milwaukee, WI 53226-3462 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 25/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002000215I | HUMANA (01) | |
1003868589 | (05) | WI |
G53090 | (02) |