Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD441399 | PA |
Y | 2080P0205X | Pediatric Endocrinologist | D83736 | MD |
N | 2080P0205X | Pediatric Endocrinologist | ME124446 | FL |
NPI | 1033375670 |
---|---|
Provider Name | Risa Michelle Wolf |
First Address | Baltimore, MD 21236-4902 |
Second Address | Baltimore, MD 21287-0011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2008 |
Last Update Date | 03/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
015497400 | (05) | FL |
151NH | FL BLUE (01) | FL |