Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 79408 | MA |
NPI | 1184641631 |
---|---|
Provider Name | Dr. Joanne Wolfe |
First Address | Boston, MA 02115-6013 |
Second Address | Boston, MA 02115-6013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3130703 | (05) | MA |
F83435 | (02) |