| NPI | 1104576701 |
|---|---|
| Former Name | KATELIN ROSE WIXSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 345986) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: LA 345986) |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2026-01-22 |