Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A96987 | CA |
N | 208600000X | Surgeon | A96987 | CA |
N | 2086S0102X | Surgical Critical Care | A96987 | CA |
Y | 2086S0127X | Trauma Surgeon | A96987 | CA |
NPI | 1346429537 |
---|---|
Provider Name | Mary M Wolfe |
First Address | Fresno, CA 93721-1431 |
Second Address | Fresno, CA 93721-1324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2007 |
Last Update Date | 16/01/2020 |